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1

Endothelial function in patients with vasculogenic erectile dysfunction  

Microsoft Academic Search

ObjectivesErectile dysfunction (ED) commonly coexists with coronary artery disease (CAD) and\\/or risk factors for atherosclerosis. Because the silent or documented atherosclerosis or vascular risk factors are very frequent, the possibility of endothelial dysfunction in ED patients is expected to be increased. Our aim was to evaluate the endothelial functions in patients with vasculogenic ED with vascular risk factors and compare

O?uz Yavuzgil; Bar?? Altay; Mehdi Zoghi; Cemil Gürgün; Meral Kay?kç?o?lu; Hakan Kültürsay

2005-01-01

2

Electrical activity of corpus cavernosum in vasculogenic and non-vasculogenic erectile dysfunction.  

PubMed

We aimed to compare the electrical activity of corpus cavernosum before and after intracavernous papaverine injection and to determine the blood lipid profile in vascular and non-vascular erectile dysfunction, and also to assess whether vascular pathology and abnormal blood lipid levels impair cavernosal smooth-muscle relaxation. We determined total cholesterol (TC), triglyceride (TG) and high-density lipoprotein (HDL) levels in peripheral and cavernosal blood in 39 patients with erectile dysfunction. Electromyography of the corpus cavernosum was performed before and after an intracavernous injection with 60 mg of papaverine in all patients. Thirty-nine impotent patients have been divided into two groups: vasculogenic erectile dysfunction (VED) and non-vasculogenic erectile dysfunction (NVED), according to colour Doppler ultrasonic flowmetry, dynamic infusion cavernosometry and the pressure difference between the brachial arterial systolic pressure and cavernosal arterial systolic pressure measurements. Biochemical values and amplitude changes were compared in both groups. The TC level was higher in both peripheral and cavernosal samples of the VED group than in the NVED group (p = 0.000), with no differences between peripheral and cavernosal blood levels within the same groups (p > 0.05). There were no significant changes in TG and HDL levels in any of the groups (p > 0.05). The mean amplitude differences before and after papaverine injection (delta A) were found to be 2.05 +/- 0.78 microV in the VED group and 4.68 +/- 2.53 microV in the NVED group, showing that the relaxation response to papaverine was more significant in the NVED than in the VED group (p = 0.003). The moderate decreases in the amplitude of electrical activity of corpus cavernosum and the higher TC levels found in the VED group can be accepted as the parameters of impairment in the relaxation of corpus cavernosum, showing the role of hypercholesterolaemia and vascular pathologies in erectile dysfunction. PMID:9458514

Atahan, O; Kayigil, O; Metin, A

1997-12-01

3

Treatment of vasculogenic erectile dysfunction by direct anastomosis of the inferior epigastric artery to the central artery to the corpus cavernosum.  

PubMed

We present a case of vasculogenic erectile dysfunction following trauma, which was treated successfully by direct anastomosis of the inferior epigastric artery to the central artery of the corpus cavernosum. This is the first report of this operative technique. Its theoretical advantages over previously described revascularization techniques include an end-to-side vascular anastomosis, possibly decreasing perianastomotic fibrosis, and regulation of new blood flow into the corporeal bodies by the neurovascular mechanism of the central artery. PMID:6460119

MacGregor, R J; Konnak, J W

1982-01-01

4

Erectile Dysfunction  

MedlinePLUS

... Other medications Other medications for erectile dysfunction include: Alprostadil self-injection. With this method, you use a fine needle to inject alprostadil (Caverject Impulse, Edex) into the base or side ...

5

[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

6

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

PubMed Central

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

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

2008-01-01

7

Erectile Dysfunction  

MedlinePLUS

... improve erectile function, there are still a number of choices. The vacuum constriction device, or vacuum pump, creates an erection mechanically, by forcing blood into the penis using a vacuum seal. Because the blood starts to ... onto the base of the penis, constricting it sufficiently so that the ...

8

Erectile dysfunction: management update  

PubMed Central

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

Fazio, Luke; Brock, Gerald

2004-01-01

9

[Pharmacotherapy of erectile dysfunction].  

PubMed

Among the drugs used to treat erectile dysfunction most common are prostaglandins El, viagra, iochimbin, vasodilators and desaggregants, vitamins, biogenic stimulators, etc. The comparative analysis of their efficacy was made in 360 patients with erectile dysfunction, primarily at subcompensated stage, aged 17-83 years. Organic and psychogenic erectile dysfunctions were diagnosed in 69 and 31% of the patients, respectively. Intracavernous injections of prostaglandin El (Caverject) were effective in 74%, transurethral alprostadil (MUSE) when adjusting the dose--in 38.7% of the patients. Iochimbin in patients with organic and psychogenic forms of erectile dysfunctions was effective in 25 and 40% of patients, respectively. In 26.3 and 19% of such patients the response was obtained after use of the combination including xantinol, nicotinate, trental, biogenic stimulators and adaptogens. Viagra was effective in 60 and 77.3% of patients with psychogenic and organic erectile dysfunctions, respectively. PMID:16856460

Kovalev, V A; Koroleva, S V; Kamalov, A A

10

Erectile Dysfunction (ED)  

MedlinePLUS

... try a medicine to help with erectile dysfunction. Sildenafil (brand name: Viagra), tadalfil and vardenafil are medicines ... is best for you. How should I take sildenafil? Follow your doctor's instructions. Usually, a man takes ...

11

Curing erectile dysfunction: Pro  

Microsoft Academic Search

This study tested the hypothesis that sildenafil daily for 1 year can cure vascular erectile dysfunction (ED). In a prospective,\\u000a randomized controlled trial, patients were assigned to two groups: group I, 50 mg of sildenafil daily at bedtime; group II,\\u000a 50 to 100 mg of sildenafil on demand. The primary efficacy measures were International Index of Erectile Function domain score

Frank Sommer

2005-01-01

12

Neurologic erectile dysfunction  

Microsoft Academic Search

\\u000a Because erection is a neurovascular event, any disease or dysfunction affecting the brain, spinal cord, cavernosus and pudendal\\u000a nerves, or receptors in the terminal arterioles and cavernosus muscles can induce erectile dysfunction (ED). The medial preoptic\\u000a area with the paraventricular nucleus has been regarded as an important integration centre for sexual drive and penile erection\\u000a in animal studies [1]. Pathological

Michael Miintener; Brigitte Schurch

13

Erectile Dysfunction Following Intravitreal Bevacizumab  

PubMed Central

Despite initial concerns regarding systemic complications, the use of intravitreal antivascular endothelial growth factor (anti-VEGF) agents for ocular disease is rapidly expanding worldwide, in terms of both the number of patients injected and its indications. To our knowledge, there are no cases in the literature reporting erectile dysfunction following the use of intravitreal bevacizumab. We postulate an organic mechanism for impaired erectile function due to systemically absorbed intravitreal bevacizumab. We describe a case of erectile dysfunction following intravitreal bevacizumab administration. Color fundus photos, fluorescein angiogram and optical coherence tomography images are presented. A 40-year-old male underwent intravitreal bevacizumab therapy for macular edema secondary to a branch retinal vein occlusion. He subsequently developed transient erectile dysfunction after each of his two bevacizumab injections. His only comorbidity was mild hypertension. Erectile dysfunction may be a side effect of intravitreal bevacizumab. The erectile dysfunction could be organic and/or psychogenic in etiology.

Yohendran, Jayshan; Chauhan, Devinder

2010-01-01

14

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.

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

2012-01-01

15

The Physiology of Erectile Dysfunction  

Microsoft Academic Search

Male erectile dysfunction is a common urologic disorder which can have a profound detrimental impact on a patient's quality of life. Normal erectile function represents a complex physiologic process requiring integrated synchronized function of vascular, neurologic, and musculoskeletal body systems, with significant psychologic factors playing a role as well. A breakdown in any one of these body systems can contribute

Shane Russell; Ajay Nehra

2003-01-01

16

Evaluation and Therapeutic Regulation of Erectile Dysfunction with Visual Stimulation Test  

Microsoft Academic Search

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

Faruk Yagci; Kemal Sarica; Emin Ozbek; Oguzkan Topcu

2002-01-01

17

Sildenafil citrate vs intracavernous alprostadil for patients with arteriogenic erectile dysfunction: a randomised placebo controlled study  

Microsoft Academic Search

We compared the effectiveness of sildenafil citrate and alprostadil in improving arterial penile inflow (peak systolic velocity (PSV)) and penile rigidity in 55 patients with erectile dysfunction caused by atherosclerosis. A total of 35 patients with pure vasculogenic impotency were randomly assigned to alprostadil (Av group; n=11), sildenafil (Sv group; n=12), or placebo (P group; n=12), and 20 patients with

M Mancini; R Raina; A Agarwal; F Nerva; G M Colpi

2004-01-01

18

Erectile dysfunction following retropubic prostatectomy.  

PubMed

Prostate cancer is the most common cancer to affect men in the UK. Treatment options depend on the grade of tumour, the patient's co-existing diseases and choice of treatment. One potentially curative option is surgery, specifically a radical retropubic prostatectomy or variation thereof. As a consequence of the surgery, men commonly experience two side-effects: urinary incontinence and erectile dysfunction (ED). This paper outlines the clinical management of ED following surgery and aims to provide an overview of how to assess a man who has developed ED and discuss the various treatment options available, along with the efficacy in terms of recovery of erections. PMID:23448953

Lalong-Muh, Julienne; Colm, Treacy; Steggall, Martin

19

Erectile dysfunction: The medicalization of male sexuality  

Microsoft Academic Search

Erectile dysfunction (ED) is a highly prevalent disorder in males that increases markedly with aging. Diagnostic and treatment approaches for the disorder have proliferated in the past decade, along with increased understanding of the underlying physiology of male erection. Two specific themes have emerged in the recent literature on the topic: 1.(a) erectile dysfunction is a socially legitimate, medically treatable

Raymond C. Rosen

1996-01-01

20

[Radiologic diagnosis of erectile dysfunction].  

PubMed

Possibilities of radiological cooperation in diagnostics and therapy of erectile dysfunction are demonstrated. Besides SKAT-testing and pharmaco-duplex-sonography, pharmaco-cavernosometry and cavernosography procure the decisive confirmation of venous leakage. The veins which are not compressable during erection can eventually be obliterated under radiological control with the help of mini-coils. Pelvic and penile arteriography are mandatory for the localization of arterial obliterations which can be treated either surgically or by angioplasty. The value of interventional radiological measures in the arterial region can be clearly substantiated in common iliac and internal iliac stenoses. However, the results obtained in the venous region by occluding interventional measures have yet to be evidenced by systematic examinations, as the surgical treatment has not shown much success up to now. PMID:1839238

Zeitler, E; Ritter, W

1991-01-01

21

Erectile dysfunction in general medicine.  

PubMed

Erectile dysfunction (ED) affects millions of men worldwide with implications that go far beyond sexual activity. ED is now recognised as an early marker of cardiovascular disease, diabetes mellitus (DM) and depression. The risk factors that are associated with ED (sedentary lifestyle, obesity, smoking, hypercholesterolaemia and the metabolic syndrome) are very similar to those for cardiovascular disease (CVD). Arguably, the awareness of ED as a symptomatic entity in the post-Viagra™ age is on the rise. Nevertheless, ED is commonly missed when evaluating patients in the hospital setting, either because of lack of consideration or awareness, or through simple embarrassment (of both clinician and patient). This article provides an overview of the aetiology, assessment and importance of ED and hopes to promote its consideration in day-to-day clinical practice. PMID:23681859

Grant, Paul; Jackson, Graham; Baig, Irfan; Quin, John

2013-04-01

22

[Yohimbine in the treatment of erectile dysfunction].  

PubMed

Iochimbin hydrochloride was given to 153 men with erectile dysfunction. The results are available for 140 of them. The ability of iochimbin in a single dose of 5-10 mg to enhance arterial blood inflow to cavernous bodies of the penis was confirmed by dynamic angiopenoscintigraphy and Doppler ultrasonography. Iochimbin hydrochloride in a mean daily dose of 15-20 mg proved effective in erectile dysfunction--38 to 84% responders depending on the type of erectile dysfunction. Occasional side effects can be relieved by reducing the drug dose. PMID:12577576

Pushkar', D Iu; Segal, A S; Bagaev, A G; Nosovitski?, P B

23

ORAL PHENTOLAMINE AS TREATMENT FOR ERECTILE DYSFUNCTION  

Microsoft Academic Search

PurposeFor most patients with erectile dysfunction oral agents are a preferred treatment option. Oral or buccal phentolamine has been shown to produce full erections in impotent subsets of study populations. We evaluate the efficacy of oral phentolamine.

ARMIN J. BECKER; CHRISTIAN G. STIEF; STEPHAN MACHTENS; DIRK SCHULTHEISS; UWE HARTMANN; MICHAEL C. TRUSS; UDO JONAS

1998-01-01

24

Metabolic Syndrome and Erectile Dysfunction  

PubMed Central

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

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

2011-01-01

25

Non Erectile Dysfunction Application of Sildenafil  

Microsoft Academic Search

Sildenafil has proven effective in the therapy of male erectile dysfunction. However, little is known about other potential beneficial effects of sildenafil. Meanwhile, first observations have been made in numerous medical disciplines and disor- ders. Small doses of sildenafil may be a useful adjunct to in- haled iloprost in the management of pulmonary hyperten- sion. In female sexual dysfunction and

Bodo Cremers; Michael Böhm

2003-01-01

26

Prevalence of erectile dysfunction: need for treatment?  

Microsoft Academic Search

Research examining the occurrence of sexual problems in nonclinical populations tends to be restricted to highly select populations. Recently, several population-based surveys surfaced in the international literature, triggered by the advent of effective pharmacological treatment for erectile dysfunction (ED). ED is a common disorder, especially among elderly men. The annual incidence in men 40–69 y of age is 26 per

E J H Meuleman; EJH Meuleman

2002-01-01

27

Group treatment of secondary erectile dysfunction  

Microsoft Academic Search

The effects of three group treatment formats on 20 men with secondary erectile dysfunction and their partners were contrasted. After a comprehensive medical and psychological screening, each couple was assigned to one of three treatment groups (Communication Technique Training, Sexual Technique Training, Combination Treatment) or to one of two control groups (Attention-Placebo, No-Treatment). Couples in the three treatment groups and

Peter R. Kilmann; Richard J. Milan; Joseph P. Boland; Howard R. Nankin; Edward Davidson; Melissa O. West; Robert F. Sabalis; Charlene Caid; Jeanne M. Devine

1987-01-01

28

Erectile dysfunction following prostatectomy: prevention and treatment  

Microsoft Academic Search

Radical prostatectomy (RP) remains the standard treatment for men with clinically localized prostate cancer, despite the range of alternative treatment modalities. Even with significant advances in surgical technique and superb results for cancer control and preservation of urinary function, erectile dysfunction (ED) following RP is a common complication. This is mainly attributed to temporary cavernous nerve damage (neuropraxia) resulting in

Ahmed Magheli; Arthur L. Burnett

2009-01-01

29

Significance of hypogonadism in erectile dysfunction  

Microsoft Academic Search

To review the role and significance of hypogonadism, defined as a low testosterone (T) level, in erectile dysfunction (ED). Review of literature. Serum T is below 3 ng\\/ml in 12% of ED patients, including 4% before and 15% after the age of 50. Replacement studies in men with severe hypogonadism demonstrate that sexual desire and arousal, as well as the frequency

Jacques Buvat; Gilbert Bou Jaoudé

2006-01-01

30

EAU Guidelines on Erectile Dysfunction: An Update  

Microsoft Academic Search

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

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

2006-01-01

31

Cognitive-Behavioral Erectile Dysfunction Treatment for Gay Men  

ERIC Educational Resources Information Center

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

Hart, Trevor A.; Schwartz, Danielle R.

2010-01-01

32

Yohimbine in erectile dysfunction: the facts  

Microsoft Academic Search

Yohimbine, a pharmacologically well-characterized ?-2-adrenoceptor antagonist with activity in the central and peripheral nervous system, has been used for over a century in the treatment of erectile dysfunction. In-depth, systematic studies in animals have shown that the drug has a remarkable positive effect on sexual performance. Meta-analyses of the few controlled, randomized human studies have consistently shown an advantage of

A Morales

2000-01-01

33

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

34

Induratio penis plastica--a factor of erectile dysfunction?  

PubMed

There are still diverse management options in Peyronie's disease and diverse opinions about the coincidence of Peyronie's disease and erectile dysfunction as well. The connection between Peyronie's disease and ED has been proved by some papers but on the other hand authors have refused to accept this claim. We have found erectile dysfunction in about 30% of our patients. We investigated 61 patients with Peyronie's disease. As diagnostic criteria assessment of angulation and erectile dysfunction are proposed. The tunica albuginea plication technique was used in 35 patients with good results. In our investigation we did not find any coincidence of Peyronie's disease with erectile dysfunction. PMID:8899481

Werner, W; Wunderlich, H; Schubert, J

1996-01-01

35

Restless Legs Syndrome and Erectile Dysfunction  

PubMed Central

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

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

2010-01-01

36

The international index of erectile function (IIEF): a multidimensional scale for assessment of erectile dysfunction  

Microsoft Academic Search

Objectives. To develop a brief, reliable, self-administered measure of erectile function that is cross-culturally valid and psychometrically sound, with the sensitivity and specificity for detecting treatment-related changes in patients with erectile dysfunction.Methods. Relevant domains of sexual function across various cultures were identified via a literature search of existing questionnaires and interviews of male patients with erectile dysfunction and of their

Raymond C. Rosen; Alan Riley; Gorm Wagner; Ian H. Osterloh; John Kirkpatrick; Avanish Mishra

1997-01-01

37

Web Based Online Diagnosis for Erectile Dysfunction Using International Index of Erectile Function (IIEF)  

Microsoft Academic Search

Most Erectile Dysfunction (ED patients are not willing to openly discuss their problems with friends and physicians. Because\\u000a of this issue, this paper proposes a web based online diagnosis of Erectile Dysfunction using International Index of Erectile\\u000a Function (IIEF) questionnaire which will give an opportunity for ED patients to asses themselves at their private surroundings\\u000a and convenient time. This system

Mohd Naim Mohd Ibrahim; F. Ibrahim; A. H. Razack

38

Stem-cell therapy for erectile dysfunction.  

PubMed

Introduction: Stem cells (SCs) have been investigated for the treatment of erectile dysfunction (ED). Areas covered: This review covers key disease targets and all 33 preclinical studies, including their use of SC types, animal models, transplantation routes, and outcome assessment methods. Expert opinion: In the past one and half years there have been more stem-cell-for-erectile-dysfunction studies than the prior 8 years combined. These new studies tend to use combinatory treatment approaches by modifying or supplementing SCs with angiogenic or neurotrophic genes or proteins. However, when considering all risks and benefits, these combinatory approaches do not seem more advantageous than single-SC approaches. Another trend is the choice of transplantation routes other than the standard intracavernous (IC) injection. However, with the exception of intravenous injection, these new transplantation approaches are more cumbersome than IC injection and yet offer no evidence of producing better outcomes. In contrast to these variations, a consensus among these studies is the suggestion that paracrine action, as opposed to cellular differentiation, is the principal therapeutic mechanism. In conclusion, IC injection of a single SC type should be the choice protocol for initial clinical trials, and this is clearly the case with two clinical trials that are currently recruiting patients. PMID:24090162

Lin, Ching-Shwun; Xin, Zhongcheng; Dai, Jican; Huang, Yun-Ching; Lue, Tom F

2013-10-03

39

Bicycle riding, perineal trauma, and erectile dysfunction: Data and solutions  

Microsoft Academic Search

Significant clinical and basic science advances in the field of sexual medicine have facilitated investigation of the link\\u000a between endothelial dysfunction and erectile dysfunction. Most sexual medicine practitioners accept the premise that in aging\\u000a men with risk factors such as increased waist circumference, diabetes, hypertension, hypogonadism, hypercholesterolemia, and\\u000a insulin insensitivity, a higher prevalence of erectile dysfunction reflects systemic vasculopathy that

Irwin Goldstein; Alan L. Lurie; John P. Lubisich

2008-01-01

40

Bicycle riding, perineal trauma, and erectile dysfunction: Data and solutions  

Microsoft Academic Search

Significant clinical and basic science advances in the field of sexual medicine have facilitated investigation of the link\\u000a between endothelial dysfunction and erectile dysfunction. Most sexual medicine practitioners accept the premise that in aging\\u000a men with risk factors such as increased waist circumference, diabetes, hypertension, hypogonadism, hypercholesterolemia, and\\u000a insulin insensitivity, a higher prevalence of erectile dysfunction reflects systemic vasculopathy that

Irwin Goldstein; Alan L. Lurie; John P. Lubisich

2007-01-01

41

Erectile dysfunction in hemodialysis: A systematic review  

PubMed Central

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

El-Assmy, Ahmed

2012-01-01

42

Erectile dysfunction: to prescribe or not to prescribe?  

PubMed

Even with the help of modern pharmacology, treatment of erectile dysfunction often remains complex, and requires taking into account the social, psychological, and behavioral dimensions of the disorder. This brief report presents a case study highlighting this complexity. PMID:15829990

Bianchi-Demicheli, F; Ortigue, S; De Ziegler, D; Damsa, C; Sekoranja, L

43

The treatment choice of elderly patients with erectile dysfunction  

Microsoft Academic Search

The aim of this study was to determine treatment preference, commitment to choice of therapy, and the influence of physical disability on treatment choice in a geriatric group of males with erectile dysfunction (E.D.) of various etiologies. Eighty-nine patients aged 65 to 83 years (mean 69.5 years) were assessed and followed at our erectile dysfunction clinic from July 1991 to

Anthony Finelli; Eric D. Hirshberg; Sidney B. Radomski

1998-01-01

44

Erectile dysfunction in heart disease patients.  

PubMed

Atherosclerosis is a general health problem that not only affects the coronary arteries but also (in men) the penile arteries, thus contributing to organic causes of erectile dysfunction (ED) in heart disease patients. These organic causes are intertwined with psychological and pharmacological causes because medication prescribed for heart disease patients may also cause ED. The incidence of ED after myocardial infarction ranges from 38 to 78%. As sexual intercourse involves physical exertion, the medical history, ventricular function determined through echocardiography, and stress testing are used to classify patients into various groups where coital activity represents a greater or lesser cardiovascular risk. The energy requirements for intercourse are not high, ranging from 3.7 metabolic equivalents (METs) of energy expenditure at resting state during the preorgasmic phase to 5 METs during orgasm. The Bruce protocol for exercise stress testing is a six-stage protocol with changes in the slope and speed of the treadmill. As a general rule, a patient who completes the first two stages of the Bruce protocol has a functional capacity greater than 7 METs, which is considered sufficient for sexual intercourse. The physician or cardiologist concerned should institute first-line treatment with oral drugs according to the indications listed below. If sexual activity is not contraindicated, the treatment of choice for ED in heart disease patients is oral therapy with sildenafil, except in those cases in which its use is contraindicated. Specific recommendations are discussed. PMID:15496852

Sainz, I; Amaya, J; Garcia, M

2004-10-01

45

Group treatment of secondary erectile dysfunction.  

PubMed

The effects of three group treatment formats on 20 men with secondary erectile dysfunction and their partners were contrasted. After a comprehensive medical and psychological screening, each couple was assigned to one of three treatment groups (Communication Technique Training, Sexual Technique Training, Combination Treatment) or to one of two control groups (Attention-Placebo, No-Treatment). Couples in the three treatment groups and the attention-placebo group participated in their respective formats in twice-weekly sessions for a total of 20 hours. The no-treatment control group received sex education and treatment after a 5-week waiting list period. All three treatment groups fostered substantial gains so that between-format differences were not statistically significant. Subject variables which predicted success/experience ratio gains included age of the male partner, perceived level of relationship adjustment, and the male partner's success/experience ratio prior to treatment. Eighty-one percent of the treated men reached the criterion of 80% or greater success/experience ratio (successful penetration and subsequent ejaculation) at the 6-month follow-up. Good nocturnal tumescence prior to treatment was correlated with a better treatment outcome than poor tumescence. PMID:3669078

Kilmann, P R; Milan, R J; Boland, J P; Nankin, H R; Davidson, E; West, M O; Sabalis, R F; Caid, C; Devine, J M

1987-01-01

46

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

47

Sildenafil in erectile dysfunction: a critical review.  

PubMed

Sildenafil citrate (Viagra) is a potent orally active cGMP-specific phosphodiesterase type 5 (PDE5) inhibitor that is effective as a peripheral conditioner in the treatment of male erectile dysfunction (ED) of organic, psychogenic or mixed aetiology. Sildenafil is the first effective oral agent in the management of ED that has had a revolutionary impact on management of ED. The present review has been subdivided into five major sections. Based on the most recent peer-reviewed publications, the first section is aimed at critically evaluating PDE5 selectivity as well as the pharmacokinetics and pharmacodynamics of the drug, mainly to assess the best doses for each group of patients (i.e. adult and elderly men). Effectiveness in a broad spectrum ED population is the subject of the second section of the review, principally reporting post-marketing company-independent results. Safety and tolerability are the key concerns of the third section, with a broad consideration of the most commonly reported adverse events. Special attention has been paid to the cardiovascular safety of the drug, chiefly outlining the positive and potentially protective cardiac effects of sildenafil. Moreover, the impact of sildenafil in special patient populations is considered, namely in men complaining of diabetes mellitus, depression, neurological disorders, renal failure and those who have undergone a radical prostatectomy. Sildenafil and the ageing male has been especially underlined. Finally, the review covers a few new potential applications of sildenafil in ED patients with regard to high-dose treatment and combination therapy. The review ends with several considerations regarding the direct and/or indirect impact of sildenafil over quality of life and quality of partnership. PMID:12841917

Salonia, Andrea; Rigatti, Patrizio; Montorsi, Francesco

2003-01-01

48

[Erectile dysfunction: reasonable diagnostics and treatment in general practice].  

PubMed

The availability of efficacious oral drugs has radically changed the diagnostic and therapeutic approach to erectile dysfunction. Complicated examinations as well as invasive treatment options have been widely abandoned. Instead the management of impotent men has become much more pragmatic and focused on the symptom. Consequently only a minority of impotent men needs to be referred to an urologist, which makes the therapy of erectile dysfunction increasingly attractive for general practitioners. However, successful treatment first of all still needs time and a genuine interest in the field of erectile dysfunction. In this article a reasonable diagnostic evaluation of impotent patients in general practice is described. Furthermore indication and use of little or non-invasive therapies are discussed. PMID:12643071

Müntener, M; Suter, St; Praz, V; Hauri, D

2003-01-29

49

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

Microsoft Academic Search

Objectives To determine the effects of erectile dysfunction and to explore the impact of treatment with sildenafil (Viagra). Design An exploratory qualitative study with semistructured interviews. Setting Men's health clinic in NHS hospital. Participants 40 men who had had erectile dysfunction and had attended the clinic during the year before interview. Main outcome measures Impact of erectile dysfunction on men,

John M Tomlinson; David Wright

2004-01-01

50

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

Microsoft Academic Search

In the 7 years since sildenafil citrate (VIAGRA) was introduced as the first oral phosphodiesterase type 5 inhibitor therapy for erectile dysfunction, it has been used to treat nearly 27 million men with erectile dysfunction worldwide. Patient populations with erectile dysfunction of varying etiologies and with diverse comorbidities have benefited from sildenafil treatment. This update focuses on relatively recent research

H Padma-Nathan

2006-01-01

51

Cardiovascular drug use and the incidence of erectile dysfunction  

Microsoft Academic Search

It is unclear whether high blood pressure per se or antihypertensive drug use causes erectile dysfunction (ED). The aim of this study was to investigate the effect of cardiovascular diseases and their concomitant medications use on the incidence of ED. The target population consisted of men aged 55, 65 or 75 years old residing in the study area in Finland

R Shiri; J Koskimäki; J Häkkinen; A Auvinen; T L J Tammela; M Hakama

2007-01-01

52

Erectile dysfunction as a harbinger for increased cardiometabolic risk  

Microsoft Academic Search

In August 2003, the Minority Health Institute (MHI) convened an Expert Advisory Panel of cardiologists and urologists to design a new practice model algorithm that uses erectile dysfunction (ED) as a clinical tool for early identification of men with systemic vascular disease. The MHI algorithm noted ED as a marker for the presence of cardiovascular disease and suggested that ED

K L Billups; A J Bank; H Padma-Nathan; S D Katz; R A Williams

2008-01-01

53

Post-traumatic erectile dysfunction: Doppler US findings  

Microsoft Academic Search

Erectile dysfunction can happen after trauma, particularly with vertebral, pelvic, or perineal injuries. Penile Doppler US findings in these patients are various, from normal to serious arterial impairment, according to the severity and the types of injuries. With neurogenic causes, Doppler US finding is usually normal, but decreased flow in cavernosal arteries may also be encountered due to combined vascular

Sun Ho Kim; Seung Hyup Kim

54

Clinical Monograph for Drug Formulary Review: Erectile Dysfunction Agents  

Microsoft Academic Search

BACKGROUND: Significant advances in the pharmacologic treatment of erectile dysfunction (ERD) have occurred in recent years, most notably the introduction of sildenafil, the first oral selective phosphodiesterase type 5 (PDE5) inhibitor, in 1998. Sildenafil quickly gained acceptance by the medical community and the public because of its broad efficacy for different types of ERD and its ease of use. Two

HELEN ELOISE CAMPBELL

2005-01-01

55

Frequency and Determinants of Erectile Dysfunction in Italy  

Microsoft Academic Search

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

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

2000-01-01

56

Gene and stem cell therapy for erectile dysfunction  

Microsoft Academic Search

Erectile dysfunction (ED) is defined as the inability to attain and\\/or maintain penile erection sufficient for satisfactory sexual performance. ED is a highly prevalent health problem with considerable impact on the quality of life of men and their partners. Although the treatment of ED with oral phosphodiesterase type V (PDE5) inhibitors is effective in a wide range of individuals, it

W Deng; T J Bivalacqua; W J G Hellstrom; P J Kadowitz

2005-01-01

57

Image forms and method for ameliorating male erectile dysfunction  

US Patent & Trademark Office Database

The use of a pharmaceutical composition for oral administration comprising a carrier and active ingredient selected from a dopamine agonist, testosterone and mixtures thereof, the composition being in the form of a fast-dispersing dosage form designed to release the active ingredient rapidly in the oral cavity for the manufacture of a medicament for treatment of male erectile dysfunction.

2002-01-29

58

Treatment of Erectile Dysfunction: What Should We Do Next?  

Microsoft Academic Search

Because sildenafil (Viagra) is scheduled to be clinically available in the near future, urologists in Japan must prepare for\\u000a changes in the treatment of erectile dysfunction. The drug will surely influence our current clinical style of diagnosis and\\u000a treatment of the dysfunction. We herein discuss this issue, referring to favorable and unfavorable effects that will be brought\\u000a about by the

Taiji Tsukamoto; Yoshikazu Sato; Hiroki Horita; Naoki Itoh

2000-01-01

59

Post-traumatic erectile dysfunction: doppler US findings.  

PubMed

Erectile dysfunction can happen after trauma, particularly with vertebral, pelvic, or perineal injuries. Penile Doppler ultrasonographic (US) findings in these patients are various, from normal to serious arterial impairment, according to the severity and type of injury. With neurogenic causes, Doppler US findings are usually normal, but decreased flow in cavernosal arteries may also be encountered due to combined vascular injury. With arteriogenic causes, relatively or absolutely decreased peak velocity in cavernosal arteries can be encountered. Alterations of penile arterial anatomy are frequently found in these patients and can be secondary changes due to proximal arterial insufficiency. After trauma in the penis or perineum, distortion or reconstruction of vascular anatomy in addition to traumatic sequelae in the erectile tissue can be directly visualized on Doppler US. Venogenic impotence can also be a result of trauma, and Doppler US findings are the same as nontraumatic venous leak. High-flow priapism is another category of post-traumatic erectile dysfunction, which can be diagnosed conclusively by Doppler US. It can be managed by angiographic embolization, and Doppler US is useful in evaluating recurrence and erectile dysfunction after embolization. PMID:16314991

Kim, Sun Ho; Kim, Seung Hyup

60

eNOS-uncoupling in age-related erectile dysfunction  

PubMed Central

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

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

2011-01-01

61

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

62

Vardenafil: A new approach to the treatment of erectile dysfunction  

Microsoft Academic Search

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

Wayne J. G. Hellstrom

2003-01-01

63

Erectile Dysfunction as a Complication of Heart Failure  

Microsoft Academic Search

Erectile dysfunction (ED) is an increasingly common problem in the aging population and has been associated with chronic heart\\u000a failure (HF), either as an epiphenomenon or even as an early marker for underlying cardiovascular disease. ED has a significant\\u000a effect on patients’ quality of life. This chapter reviews ED in patients with HF and prevention and treatment based on current

Afshan Baraghoush; Anita Phan; Robert D. Willix Jr; Ernst R. Schwarz

2010-01-01

64

Hypogonadism in DM1 and its relationship to erectile dysfunction  

Microsoft Academic Search

Myotonic dystrophy type 1 (DM1) is characterized by both a premature appearance of age-related phenotypes and multiple organ\\u000a involvement, which affects skeletal and smooth muscle as well as the eye, heart, central nervous system, and endocrine system.\\u000a Although erectile dysfunction (ED) is a frequent complaint in patients with DM1, it has not been investigated in great depth.\\u000a Hypogonadism, which is

Giovanni Antonini; Alessandro Clemenzi; Elisabetta Bucci; Emanuela De Marco; Stefania Morino; Antonella Di Pasquale; Pamela Latino; Gilda Ruga; Andrea Lenzi; Nicola Vanacore; Antonio F. Radicioni

65

Epidemiology of Erectile Dysfunction and Key Risk Factors  

Microsoft Academic Search

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

Ray C. Rosen; Varant Kupelian

66

Post-traumatic erectile dysfunction: Doppler US findings  

Microsoft Academic Search

Erectile dysfunction can happen after trauma, particularly with vertebral, pelvic, or perineal injuries. Penile Doppler ultrasonographic\\u000a (US) findings in these patients are various, from normal to serious arterial impairment, according to the severity and type\\u000a of injury. With neurogenic causes, Doppler US findings are usually normal, but decreased flow in cavernosal arteries may also\\u000a be encountered due to combined vascular

Sun Ho Kim; Seung Hyup Kim

2006-01-01

67

Annual Cost of Erectile Dysfunction to UK Society  

Microsoft Academic Search

Objective: The objective of this study was to estimate the annual socioeconomic burden imposed by erectile dysfunction (ED) on UK society. Design and Setting: Health service resource use attributable to ED during 1997\\/1998 was obtained from appropriate databases and a panel of 22 hospital specialists comprising urologists, genito-urinary physicians, diabetologists and sexual health physicians. National unit resource costs at 1996\\/1997

Jonathan M. Plumb; Julian F. Guest

1999-01-01

68

Current use of penile implants in erectile dysfunction  

Microsoft Academic Search

Penile implants became popular with the introduction of effective models more than 30 years ago. Today they play a secondary\\u000a but definitive role in the treatment of erectile dysfunction at times when more conservative therapies have failed. Improvements\\u000a in reducing the incidence of infection, treating infection with antiseptic washes, enhancing device longevity, and instituting\\u000a new techniques to manage complicated implantation

John J. Mulcahy; Steven K. Wilson

2006-01-01

69

Non-pharmacologic Erectile Dysfunction Treatments After Prostate Cancer Therapy  

Microsoft Academic Search

Erectile dysfunction (ED) after treatment for prostate cancer (radical prostatectomy, radiotherapy, or androgen deprivation\\u000a therapy) is common. Systemic therapy with the PDE5 inhibitors is successful in a lower percentage of these patients than it\\u000a is in men with ED of other etiologies. Penile injection therapy often results in usable erections in these men but its acceptability\\u000a may be limited because

Drogo K. Montague

70

[Intracavernous injection: a treatment modality for erectile dysfunction].  

PubMed

A 56-year-old man presented with a 12-year history of erectile dysfunction, which caused him extreme distress with episodes of depression. Attempts with sildenafil did not improve his erections. We tried intracavernous injection of alprostadil which enabled the patient to achieve a moderate erection. Thus, we instructed the patient for self-injection, which led to sufficient erections over the following months. We then restarted with tadalafil as a monotherapy which then was successful. PMID:23576167

Uche-Holub, E; Thierling, U; Giessing, M; Neumann, N J

2013-04-01

71

Management of erectile dysfunction after radical prostatectomy in 2007  

Microsoft Academic Search

As radical prostatectomy (RP) remains a commonly used procedure in the treatment of clinically localized prostate cancer,\\u000a we critically analyzed the evidence suggesting the role of pharmacological prophylaxis and treatment of erectile dysfunction\\u000a (ED) after surgery. Systematic literature review using Medline and Cancerlit from January 1997 to December 2006. Abstracts\\u000a published in the journals European Urology, The Journal of Urology,

Alberto Briganti; Andrea Salonia; Andrea Gallina; Felix K.-H. Chun; Pierre I. Karakiewicz; Markus Graefen; Hartwig Huland; Patrizio Rigatti; Francesco Montorsi

2007-01-01

72

Gene therapy and erectile dysfunction: the current status  

Microsoft Academic Search

Current available treatment options for erectile dysfunction (ED) are effective but not without failure and\\/or side effects. Although the development of phosphodiesterase type 5 (PDE5) inhibitors (i.e. sildenafil, tadalafil and vardenafil) has revolutionized the treatment of ED, these oral medications require on-demand access and are not as effective in treating ED related to diabetic, post-prostatectomy and severe veno-occlusive disease states.

David H. W. Lau; Sashi S. Kommu; Emad J. Siddiqui; Cecil S. Thompson; Robert J. Morgan; Dimitri P. Mikhailidis; Faiz H. Mumtaz

2007-01-01

73

Pelvic venoablation with ethanol for the treatment of erectile dysfunction due to veno-occlusive dysfunction  

Microsoft Academic Search

Objectives. To perform pelvic venoablation with ethanol injection into the deep dorsal vein for the treatment of 10 patients with venogenic erectile dysfunction. This procedure was easily performed without any selective embolization technique. The efficacy and safety of this technique are discussed.Methods. A total of 10 patients with veno-occlusive dysfunction, severe enough to make vaginal insertion impossible, underwent pelvic venoablation

Yoshiji Miwa; Rikiya Shioyama; Yasuhiko Itou; Hiroshi Kanamaru; Kenichiro Okada

2001-01-01

74

[About the improvement of urologic care for soldiers with erectile dysfunction].  

PubMed

Organizational concepts of improvement of urological aid given to military men with erectile dysfunction. The reasons for insufficiency of urological aid rendered to military men with erectile dysfunction were established. The algorithm of its diagnostics was developed. Complete and reduced volume of urological aid with reference to the existing medical and diagnostic capacities of military medical and preventive treatment facilities has been developed. Organizational concepts of improvement of urological aid given to the patients with erectile dysfunction have been determined. PMID:22448498

Shestaev, A Iu; Savchenko, I F; Kushnirenko, N P; Kushnirenko, K N; Pitomtsev, I M; Skiba, M O; Iantsev, A A

2011-12-01

75

Erectile Dysfunction and Hypertension: Impact on Cardiovascular Risk and Treatment  

PubMed Central

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

Javaroni, Valter; Neves, Mario Fritsch

2012-01-01

76

Severe erectile dysfunction is a marker for hyperprolactinemia.  

PubMed

The need for routine prolactin (PRL) measurement in the initial evaluation of erectile dysfunction (ED) has been questioned because of the low rate of hyperprolactinemia (HP) in these men and the costs involved. In addition, it is widely thought that sexual desire problems are a good clinical marker for HP and/or low testosterone in men with ED. Within a 15-month period, 844 consecutive PRL and sexual hormone determinations were conducted in men at the Kingston General Hospital. Of these patients, 138 were comprehensively evaluated at the first visit for ED and completed the International Index of Erectile Function (IIEF). In the 138 patients, 2.2% had severe hyperprolactinemia (>35 ng/ml), within the range of 1-5% previously reported. No correlation between initial prolactin value and the sexual desire domain or the erectile function domain (EFD) of the IIEF was found for this population. However, all cases of severe HP were found to occur in men who scored less than 10 in the EFD of the IIEF. Low libido is widely accepted as a marker of HP. In this study, HP was found in patients not reporting major problems with a desire disorder. Clinically significant HP may be reliably found with routine biochemical evaluation and in this series was not detected in patients with EFD scores above 10. A routine PRL measurement is inexpensive and early detection of a serious and treatable disease may afford greater therapeutic success. PMID:11525317

Johri, A M; Heaton, J P; Morales, A

2001-06-01

77

Coincidence of induratio penis plastica and erectile dysfunction.  

PubMed

There are still diverse management options in Peyronie's disease and diverse opinions about the coincidence of Peyronie's disease and erectile dysfunction (ED) as well. The connection between Peyronie's disease and ED has been proved by some articles, but on the other hand authors have refused this fact. We found ED in about 30% of our patients suffering from Peyronie's disease. We have investigated 61 patients with Peyronie's disease. A diagnostic pattern for evaluation of angulation and ED are proposed. The tunica albuginea plication technique was used in 35 patients with good results. In our investigation we cannot find any coincidence of Peyronie's disease with ED. PMID:9563147

Wunderlich, H; Werner, W; Schubert, J

1998-01-01

78

The erectile–endothelial dysfunction nexus: new opportunities for cardiovascular risk prevention  

Microsoft Academic Search

Erectile and endothelial dysfunction are common in individuals with multiple cardiovascular risk factors and are longitudinal predictors of cardiovascular events. The pathogenesis of both endothelial and erectile dysfunction is intimately linked through increased expression and activation of endothelial nitric oxide synthase, and the subsequent physiological actions of nitric oxide. Endothelial production of nitric oxide by endothelial nitric oxide synthase in

Kew-Kim Chew; Bronwyn GA Stuckey; Gerald F Watts

2007-01-01

79

Bulbocavernosus reflex studies and autonomic testing in the diagnosis of erectile dysfunction  

Microsoft Academic Search

The electrophysiologic evaluation of patients with erectile dysfunction presents an important diagnostic challenge. The bulbocavernosus reflex (BCR) latency has been commonly used to evaluate these disorders. However, it is a measure of somatic penile innervation, whereas erection is primarily dependent on autonomic function. We evaluated 195 men with erectile dysfunction over a 3 year period. Each had electrophysiologic studies, nerve

Shawn J Bird; Philip M Hanno

1998-01-01

80

YOHIMBINE FOR ERECTILE DYSFUNCTION: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CLINICAL TRIALS  

Microsoft Academic Search

PurposeErectile dysfunction is a common problem, particularly in diabetics. It is associated with a considerable burden of suffering. No generally accepted drug treatment exists. We systematically reviewed and meta-analyzed all randomized, placebo controlled trials of yohimbine monotherapy for erectile dysfunction to determine its therapeutic efficacy. Our secondary aim was to evaluate the safety of yohimbine.

E. Ernst; M. H. Pittler

1998-01-01

81

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

Microsoft Academic Search

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

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

1998-01-01

82

[Combined treatment of patients with erectile dysfunction and urination disorders].  

PubMed

The article presents the results of the study aimed to the evaluation the efficacy of combination therapy with alpha1-blocker (tamsulosin) and phosphodiesterase type 5 inhibitor (sildenafil) in patients with urination disorders and erectile dysfunction (ED). A pilot observational study involving 60 men aged from 50 and 80 years divided into 3 groups of 20 people was performed. Group 1 of patients received sildenafil 25 mg daily (dynamico), Group 2--tamsulosin 0.4 mg daily (Omnic-Ocas), and Group 3--tamsulosin 0.4 mg (Omnic-Ocas) and sildenafil 25 mg (dynamico) daily. The visits were carried out at the stage of screening, further--every 10 days (a total number--4 visits). Combination therapy of urination disorders and ED contributed to the significant improvement in uroflowmetry, the stopping of complaints according to the IPSS and IIEF-15 questionnaires, and improving the quality of life (according to the QoL questionnaire). Combination therapy significantly decreased obstructive and irritative symptoms, increased the maximum urine flow rate within the period of observation, as well as significantly decreased the residual urine volume, more pronounced when compared with monotherapy. Significant positive effect on erectile component and all components of the overall satisfaction in the sexual sphere were registered, that as a consequence led to the positive impact on the quality of life in patients treated with PDE5 inhibitor. Given the high prevalence of urinary disorders and erectile dysfunction, combined therapy with alpha1-blockers and PDE5 inhibitors in this case should be a promising area for drug therapy. PMID:23987045

Kamalov, A A; Osmolovski?, B E; Okhobotov, D A; Khodyreva, L A; Takhiradze, T B; Takhiradze, A M; Gevorkian, A R

83

Erectile dysfunction and coronary artery disease in patients with diabetes.  

PubMed

The review deals with recent findings regarding the association between erectile dysfunction (ED) and coronary artery disease (CAD) in patients with diabetes. Indeed recent longitudinal studies have shown that ED is able to predict future cardiovascular events not only in nondiabetic but also in diabetic patients. In addition, in diabetic patients ED seems to be strongly associated with the presence of silent CAD. The mechanism by which ED is linked to CAD seems to be the presence of endothelial dysfunction. This pathophysiological mechanism has been extensively analysed. The possible clinical usefulness of ED to identify diabetic patients with silent CAD or at particularly high cardiovascular risk has been discussed in the review. At last, the review reports current guidelines and recent data available in the literature on the treatment of ED in patients with and without CAD and on the prevention of CAD in patients with ED. PMID:21348816

Gazzaruso, Carmine; Coppola, Adriana; Giustina, Andrea

2011-03-01

84

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

PubMed

Acute ST elevation myocardial infarction has high mortality and morbidity rates. The majority of patients with this condition face erectile dysfunction in addition to other health problems. In this study, we aimed to investigate the effects of two different reperfusion strategies, primary angioplasty and thrombolytic therapy, on the prevalence of erectile dysfunction after acute myocardial infarction. Of the 71 patients matching the selection criteria, 45 were treated with primary coronary angioplasty with stenting, and 26 were treated with thrombolytic agents. Erectile function was evaluated using the International Index of Erectile Function in the hospital to characterize each patient's sexual function before the acute myocardial infarction and 6 months after the event. The time required to restore blood flow to the artery affected by the infarct was found to be associated with the occurrence of erectile dysfunction after acute myocardial infarction. The increase in the prevalence of erectile dysfunction after acute myocardial infarction was 44.4% in the angioplasty group and 76.9% in the thrombolytic therapy group (P=0.008). In conclusion, this study has shown that reducing the time of reperfusion decreases the erectile dysfunction prevalence, and primary angioplasty is superior to thrombolytic therapy for decreasing the prevalence of erectile dysfunction after acute myocardial infarction. PMID:22796737

Akdemir, Ramazan; Karakurt, Ozlem; Orcan, Salih; Karakoyunlu, Nihat; Balci, Mustafa Mucahit; Sa?nak, Levent; Ersoy, Hamit; Vatan, Mehmet Bulent; Kilic, Harun; Yeter, Ekrem

2012-07-16

85

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

PubMed Central

Acute ST elevation myocardial infarction has high mortality and morbidity rates. The majority of patients with this condition face erectile dysfunction in addition to other health problems. In this study, we aimed to investigate the effects of two different reperfusion strategies, primary angioplasty and thrombolytic therapy, on the prevalence of erectile dysfunction after acute myocardial infarction. Of the 71 patients matching the selection criteria, 45 were treated with primary coronary angioplasty with stenting, and 26 were treated with thrombolytic agents. Erectile function was evaluated using the International Index of Erectile Function in the hospital to characterize each patient's sexual function before the acute myocardial infarction and 6 months after the event. The time required to restore blood flow to the artery affected by the infarct was found to be associated with the occurrence of erectile dysfunction after acute myocardial infarction. The increase in the prevalence of erectile dysfunction after acute myocardial infarction was 44.4% in the angioplasty group and 76.9% in the thrombolytic therapy group (P=0.008). In conclusion, this study has shown that reducing the time of reperfusion decreases the erectile dysfunction prevalence, and primary angioplasty is superior to thrombolytic therapy for decreasing the prevalence of erectile dysfunction after acute myocardial infarction.

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

2012-01-01

86

Vardenafil: a new approach to the treatment of erectile dysfunction.  

PubMed

Vardenafil is a phosphodiesterase type-5 (PDE-5) inhibitor developed as an oral therapy for erectile dysfunction (ED). Multiple phase 3 clinical trials have been completed and vardenafil is expected to launch worldwide in 2003. Two pivotal, randomized, double-blind, multicenter studies have evaluated the use of vardenafil in men with ED. Vardenafil improved the rate of achieving and maintaining an erection during sexual intercourse. Improvement also was noted in other aspects of sexual function, including confidence, orgasmic function, and overall satisfaction. Vardenafil produces clinically and statistically significant improvements in erectile function regardless of age, baseline severity, and etiology and is efficacious for the treatment of ED in diabetic and postprostatectomy patients. Vardenafil has a rapid onset of action and completion of successful sexual intercourse is possible for some patients 16 minutes after its administration. Twenty milligrams of vardenafil has sustained long-term efficacy by providing up to 92% of patients with improved erections during more than 2 years of treatment. Vardenafil is well tolerated, with an adverse event profile typical of the class of PDE-5 inhibitors. The most common adverse events were headache, flushing, rhinitis, and dyspepsia, which were mild or moderate and generally decreased with continued treatment. Vardenafil may be associated with transient reductions in blood pressure and commensurate increases in heart rate, with the overall incidence of cardiovascular-related adverse events similar to that of placebo. PMID:14622502

Hellstrom, Wayne J G

2003-12-01

87

Prevalence and medical management of erectile dysfunction in Asia  

PubMed Central

Erectile dysfunction (ED) is an important worldwide health issue that has a significant negative impact on the quality of life and life satisfaction of both the affected individual and his partner. Here we review the prevalence of ED in Asia, associated factors that may influence sexual attitudes and sexual behaviours, and randomized clinical trials (RCTs) of phosphodiesterase-5 (PDE-5) inhibitors to evaluate the clinical efficacy and safety of PDE-5 inhibitors in Asian men. We searched for English-language articles in MEDLINE and PubMed from January 2000 to September 2010. Our results showed that the overall reported prevalence rate of ED in Asia ranged widely, from 2% to 88%. This finding indicates that ED is a common and major health problem in this region. However, sociocultural and economic factors in Asia prevent people from seeking and obtaining appropriate medical care. We found reports on five kinds of PDE-5 inhibitors for the management of ED: sildenafil, vardenafil, tadalafil, udenafil and mirodenafil. The results of RCTs showed that these five PDE-5 inhibitors are more effective than placebo in improving erectile function in Asian men with ED and that these drugs have similar efficacy and safety profiles.

Park, Kwangsung; Hwang, Eu Chang; Kim, Sun-Ouck

2011-01-01

88

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

PubMed Central

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

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

2004-01-01

89

[Erectile dysfunction. An important manifestation of autonomic diabetic neuropathy].  

PubMed

In Germany, some 4-6 million men, including 1.2 million diabetics, suffer from erectile dysfunction (ED). Various other diseases including heart disease, hypertension, arteriosclerosis, hyperlipidemia, endocrine disorders, chronic renal insufficiency, prior radical prostatectomy, neurological diseases, trauma and the abuse of alcohol, tobacco, and side effects of medications, are frequently associated with ED. Medical history, clinical examination, routine blood chemistry and sexual hormone levels may help clarify the etiology of ED. Normally, relaxation of the smooth muscles of the corpus cavernosum--mediated by cGMP and cAMP--together with dilatation of penile arteries and occlusion of venous outflow, results in an erection. The oral type V phosphodiesterase inhibitor, Sildenafil, or prostaglandin E1 injection elevates the cGMP and cAMP levels, respectively. Other therapeutic options include mechanical aids, surgery, hormone replacement or sublingual apomorphine. Since 1998, Sildenafil, an effective, simple and safe oral treatment, has been available. PMID:12532521

Hilz, M J

2002-11-21

90

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.

Burke, Ryan M; Evans, Jeffery D

2012-01-01

91

Increased risk of erectile dysfunction among males with central serous chorioretinopathy - a retrospective cohort study.  

PubMed

Purpose:? Central serous chorioretinopathy (CSCR) mostly affects middle-aged men and has been associated with stress and hypercortisolism. We hypothesized that some factors prone to inducing CSCR could also have a harmful effect on erectile function. This study aimed to investigate the risk of subsequent erectile dysfunction after CSCR using Taiwan National Health Insurance Research Database. Methods:? The study cohort (n?=?1220) consisted of newly diagnosed CSCR men aged 19-64?years between 1999 and 2007, and men matched for age, monthly income and time of enrolment were randomly selected as the control group (n?=?10870). Cox proportional hazard regressions were performed to calculate the hazard ratios (HR) of clinically diagnosed erectile dysfunction (including organic origin and/or psychogenic origin) for the two groups. Erectile dysfunction-free survival analysis was assessed using a Kaplan-Meier method. Results:? Twenty-five patients (2.0%) from the CSCR cohort and 103 (0.9%) from the control group were diagnosed erectile dysfunction clinically during a mean observation period of 4.3?years. Patients with CSCR had a significantly higher incidence of erectile dysfunction diagnosis than those without CSCR (p?erectile dysfunction diagnosis than the matched controls. The adjusted HR for organic and psychogenic erectile dysfunction were 2.14 (95% CI: 1.34-3.44) and 3.83 (95% CI: 1.47-10.01), respectively. Conclusions:? Central serous chorioretinopathy was independently associated with an increased risk of being diagnosed with erectile dysfunction. PMID:22998678

Tsai, Der-Chong; Huang, Chin-Chou; Chen, Shih-Jen; Chou, Pesus; Chung, Chia-Min; Chan, Wan-Leong; Huang, Po-Hsun; Lin, Shing-Jong; Chen, Jaw-Wen; Leu, Hsin-Bang

2012-09-23

92

Restoring a Normal Sexual Response: The Ultimate Goal of Erectile Dysfunction Therapy  

Microsoft Academic Search

Erectile dysfunction may compromise quality of life for more than 30 million European men (and their partners). Although more likely with advancing age, erectile insufficiency can be effectively and safely treated and is no longer considered an inevitable consequence of aging. One potential treatment, the investigational agent tadalafil, is a potent, selective, reversible inhibitor of phosphodiesterase type 5 with a

Hartmut Porst

2002-01-01

93

Penile prosthesis implantation in the treatment of Peyronie's disease and erectile dysfunction  

Microsoft Academic Search

Although men afflicted with Peyronie's disease (PD) usually have a number of treatment options, those who also present with erectile dysfunction (ED) arising from unknown or iatrogenic causes are not easily treated. Surgical straightening procedures that have been used to treat PD may not restore erectile function and failure to straighten the penis with surgery may be the result of

CC Carson

2000-01-01

94

An assessment of patient-reported outcomes for men with erectile dysfunction: Pfizer's perspective  

Microsoft Academic Search

Patient-reported outcomes (PROs) for men with erectile dysfunction (ED) have blossomed in the published literature and at professional conferences. These outcomes have been central to study the science of ED itself and to evaluate efficacy of treatment for men with ED. In this review article we highlight and distinguish among seven key PROs: the International Index of Erectile Function, for

J C Cappelleri; V J Stecher

2008-01-01

95

Multicenter study of the treatment of erectile dysfunction with transurethral alprostadil (MUSE) in Korea  

Microsoft Academic Search

A Korean multicenter study was conducted to assess the effectiveness of transurethral alprostadil with MUSE in 334 subjects with chronic erectile dysfunction (ED) who were enrolled in 21 clinical centers. Patients with psychogenic impotence comprised about 30% of subjects. Intraurethral alprostadil was titrated in a stepwise fashion in the clinics from 250 to 500 or 1000 mcg based on erectile

SC Kim; TY Ahn; HK Choi; NG Choi; TG Chung; WS Chung; TK Hwang; JS Hyun; GW Jung; CI Kim; JJ Kim; SW Kim; CH Lee; KS Lee; WH Lee; KS Min; KH Moon; JS Paick; JK Seo; KK Seo; JS Shin; YR Yoon; WC Lee

2000-01-01

96

EFFICACY AND SAFETY OF TRANSURETHRAL ALPROSTADIL IN PATIENTS WITH ERECTILE DYSFUNCTION FOLLOWING RADICAL PROSTATECTOMY  

Microsoft Academic Search

PurposeA retrospective analysis of the MUSE**VIVUS, Inc., Menlo Park, California. clinical trial was performed to evaluate the efficacy and safety of transurethral alprostadil in patients with erectile dysfunction after radical prostatectomy.

RAYMOND A. COSTABILE; MARIANNE SPEVAK; IRVING J. FISHMAN; FRED E. GOVIER; WAYNE J. G. HELLSTROM; RIDWAN SHABSIGH; KERRY J. NEMO; JOSHUA L. RAPPORT; PETER Y. TAM; KARA L. M. WELDON; NEIL GESUNDHEIT

1998-01-01

97

Regular Intercourse Protects Against Erectile Dysfunction: Tampere Aging Male Urologic Study  

Microsoft Academic Search

BACKGROUND: Erectile dysfunction is common among men aged more than 60 years. Its cause involves both physiologic and psychosocial factors. METHODS: To evaluate the effects of coital frequency on subsequent risk of erectile dysfunction, data were analyzed from a population-based 5-year follow-up study that was conducted in Pirkanmaa, Finland, using postal questionnaires. Assessment was based on the 5-item version of

Juha Koskimäki; Rahman Shiri; Teuvo Tammela; Jukka Häkkinen; Anssi Auvinen

98

Smoking and erectile dysfunction: findings from a representative sample of Australian men  

Microsoft Academic Search

Objectives: To examine whether there is an association between smoking and erectile dysfunction in a representative sample of Australian men.Design: Secondary analysis of cross-sectional survey data from the Australian Study of Health and Relationships.Participants: 8367 Australian men aged 16–59 years.Main outcome measures: Erectile dysfunction was identified in men who reported having had trouble keeping an erection when they wanted to,

C Millett; L M Wen; C Rissel; A Smith; J Richters; A Grulich; R de Visser

2006-01-01

99

Intraurethral alprostadil for treatment of erectile dysfunction in patients with spinal cord injury  

Microsoft Academic Search

Objectives. To assess the efficacy of intraurethral prostaglandin E1 (alprostadil, MUSE) in treating erectile dysfunction in patients with spinal cord injury (SCI).Methods. Intraurethral alprostadil was tested in 15 patients with SCI to evaluate its effectiveness in treating SCI-associated erectile dysfunction. All patients were at least 1 year after injury, and all had previously used intracavernosal injections successfully (Schramek’s grade 5

Donald R Bodner; Christopher A Haas; Beverle Krueger; Allen D Seftel

1999-01-01

100

Association between Smoking and Erectile Dysfunction: A Population-based Study  

Microsoft Academic Search

The association between smoking and erectile dysfunction was evaluated in a cohort of 2,115 Caucasian men, aged 40-79 years, randomly selected from Olmsted County, Minnesota. Smoking status was assessed by questionnaire; during the fourth biennial examination, erectile dysfunction was assessed with the Brief Male Sexual Function Inventory. Of the 1,329 men with a regular sexual partner, 173 were current smokers,

Naomi M. Gades; Ajay Nehra; Debra J. Jacobson; Michaela E. McGree; Cynthia J. Girman; Thomas Rhodes; Rosebud O. Roberts; Michael M. Lieber

101

Use of intracavernous injection of prostaglandin E1 for neuropathic erectile dysfunction  

Microsoft Academic Search

The administration and suitability of intracavernous PGE-1 in men with neuropathic erectile dysfunction is reported herein. Twenty-seven men with neuropathic erectile dysfunction (SCI, 14; multiple sclerosis, 7; discogenic disease, 6) were evaluated and treated with intracavernous PGE-1. An average of 3.2 office sessions were required to learn adequate self-injection technique and determine optimal dosage requirements. Initial dosage for SCI men

I H Hirsch; R L Smith; M B Chancellor; D H Bagley; J Carsello; W E Staas

1994-01-01

102

Erectile dysfunction in men with congenital heart disease.  

PubMed

There has been a tremendous focus on gynecologic health with the increasing number of women with congenital heart disease (CHD). Conversely, experience in providing sexual health screening to men with CHD is lacking. The purpose of this study was to identify sexual health issues in men with CHD. An anonymous survey was distributed to men in our adult CHD clinic. Age, type of CHD, medications, detailed sexual history including cardiovascular symptoms with intercourse, erectile dysfunction (ED), and willingness to discuss ED with a physician was obtained. A logistic regression analysis was performed to analyze the relation between medications, CHD complexity, and ED; 86 men completed the survey with a mean age of 34 +/- 10 years. The prevalence of ED was 38%. Men were treated with cardiac medications including beta blockers (BB; 24%), angiotensin-converting enzyme (ACE) inhibitors (8%), calcium-channel blockers (6%), and combination BB and ACE inhibitor therapy (16%). Men on BB were 3.13 times more likely to report ED (p = 0.045). Complexity of CHD did not increase the likelihood of ED symptoms (p >0.10). Although most men attributed symptoms to their underlying CHD, most were willing to discuss issues of ED with their cardiologist. In conclusion, ED is prevalent in young men with CHD. Although an emotional component may contribute, certain medications may exacerbate symptoms. PMID:19064032

Cook, Stephen C; Arnott, Lindsay M; Nicholson, Lisa M; Cook, Lindsay R; Sparks, Elizabeth A; Daniels, Curt J

2008-09-24

103

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.

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

2012-01-01

104

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.

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

2012-01-01

105

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

Microsoft Academic Search

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

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

2005-01-01

106

Prevention of cardiovascular disease by the early identification of erectile dysfunction  

Microsoft Academic Search

Both erectile dysfunction (ED) and vascular disease share the same risk factors and the two conditions often coexist, with endothelial dysfunction being the common underlying pathophysiology. Up to two-thirds of all patients with clinically evident coronary artery disease (CAD) have ED. Because of their smaller size, the same degree of lipid plaque burden has a greater effect on the penile

G Jackson

2008-01-01

107

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

Microsoft Academic Search

Erectile dysfunction (ED) commonly results from endothelial dysfunction of the systemic vasculature. Although phosphodiesterase type 5 (PDE-5) inhibitors are effective at treating most cases of ED, they must be taken routinely and are ineffectual for a meaningful number of men. In recent years gene and stem cell-based therapies targeted at the penile endothelium have been gaining momentum in preclinical studies.

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

2008-01-01

108

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

Microsoft Academic Search

Phentolamine mesylate is an alpha-1 and alpha-2 selective adrenergic receptor antagonist which has undergone clinical trials for erectile dysfunction treatment. Biochemical and physiological studies in human erectile tissue have revealed a high affinity of phentolamine for alpha-1 and alpha-2 adrenergic receptors. Based on pharmacokinetic studies, it is suggested that 30–40 min following oral ingestion of 40 or 80 mg of

I Goldstein

2000-01-01

109

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

Microsoft Academic Search

Vacuum erection devices (VED) are becoming first-line therapies for erectile dysfunction and preservation (rehabilitation)\\u000a of erectile function following treatment for prostate cancer. Currently, phosphodiesterase-5 inhibitors have limited efficacy\\u000a in elderly patients or patients with moderate to severe diabetes, hypertension, and coronary artery disease. Alternative therapies,\\u000a such as VED, have emerged as a primary option for patients refractory to oral therapy.

Craig D. Zippe; Geetu Pahlajani

2008-01-01

110

Cardiovascular drug use and the incidence of erectile dysfunction.  

PubMed

It is unclear whether high blood pressure per se or antihypertensive drug use causes erectile dysfunction (ED). The aim of this study was to investigate the effect of cardiovascular diseases and their concomitant medications use on the incidence of ED. The target population consisted of men aged 55, 65 or 75 years old residing in the study area in Finland in 1999. Questionnaires were mailed to 2837 men in 1999 and to 2510 of them 5 years later. The follow-up sample consisted of 1665 men (66% of those eligible) who responded to both baseline and follow-up questionnaires. Men free of moderate or severe ED at baseline (N=1000) were included in the study. ED was assessed by two questions on subject ability to achieve or maintain an erection sufficient for intercourse. Poisson regression model was used in the multivariable analyses. The risk of ED was higher in men suffering from treated hypertension or heart disease than in those with the untreated condition. The risk of ED was higher in men using calcium channel inhibitor (adjusted relative risk (RR)=1.6, 95% confidence interval (CI) 1.0-2.4), angiotensin II antagonist (RR=2.2, 95% CI 1.0-4.7), non-selective beta-blocker (RR=1.7, 95% CI 0.9-3.2) or diuretic (RR=1.3, CI 0.7-2.4) compared with non-users. ED was not associated with using organic nitrates, angiotensin-converting enzyme inhibitors, selective beta-blockers and serum lipid-lowering agents. In summary, calcium channel inhibitors, angiotensin II antagonists, non-selective beta-blockers and diuretics may increase the risk of ED. PMID:16900205

Shiri, R; Koskimäki, J; Häkkinen, J; Auvinen, A; Tammela, T L J; Hakama, M

2006-08-10

111

The association between TNF-? and erectile dysfunction complaints.  

PubMed

Inflammatory markers like tumour necrosis factor-alpha (TNF-?) have been related to erectile dysfunction (ED) and may interact with other cardiovascular risk factors such as obstructive sleep apnoea syndrome (OSAS). The aim of this study was to examine the inflammatory, metabolic and hormonal profile of men with or without ED complaints and/or OSAS recruited through the Epidemiologic Sleep Study (EPISONO). A sample of 363 men completed sexual questionnaires for ED and had physical and blood examinations. OSAS was evaluated by polysomnography and clinical assessment. The blood samples were used for determination of TNF-?, interleukin-6, leptin, cholesterol and fractions, triglycerides, homocysteine, glucose and hormonal levels. After controlling for confounding factors, men with ED complaints presented higher systolic blood pressure and TNF-?, independent of OSAS. Significant interaction between ED and OSAS was only observed for neck circumference, which was higher in ED men with OSAS than men with OSAS without ED and men with ED without OSAS. Binary logistic regression showed that the predictor factors for ED were age >43 years, myocardial infarction events, TNF-? and systolic blood pressure. Finally, a receiver-operating characteristics curve suggested a cut-off point of 9.95 pg/mL for TNF-? with sensitivity of 60% and specificity of 59% in men with ED complaints. Furthermore, there was a significant association between high levels of TNF-? (>9.95 pg/mL) and the presence of ED complaints. The results showed that there was an association between TNF-? levels and ED complaints in men independent of OSAS. PMID:24123864

Matos, G; Hirotsu, C; Alvarenga, T A; Cintra, F; Bittencourt, L; Tufik, S; Andersen, M L

2013-10-07

112

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

PubMed

The global burden of erectile dysfunction (ED) is increasing. It is estimated that 8-19% of men in Europe have ED and that by 2025 the prevalence of ED worldwide will reach 322 million. The gold standard therapy for ED is an oral phosphodiesterase type 5 (PDE5) inhibitor, but they are not suitable for everyone; approximately 25% of patients do not respond to this therapy and it is contraindicated in others, e.g. those with vascular disease. When PDE5 inhibitors are not suitable, available options include intraurethral and intracavernosal alprostadil - a synthetic vasodilator chemically identical to the naturally occurring prostaglandin E(1) indicated for the treatment of ED. Intraurethral alprostadil is delivered by the Medicated System for Erection (MUSE).- a single-use pellet containing alprostadil suspended in polyethylene glycol administered using an applicator. It is recommended that intraurethral alprostadil be initiated at a dose of 500??g, as it has a higher efficacy than the 250??g dose, with minimal differences with regard to adverse events. Data from key clinical studies of intraurethral alprostadil show that it has a fast onset of effect and a good safety profile, with no occurrences of priapism, fibrosis (as seen with intracavernosal injection) or the typical systemic effects observed with oral ED pharmacological treatments. Intraurethral alprostadil has been associated with high patient preference, acceptance rates and quality of life versus intracavernosal injection due to its ease of administration. Evidence has shown that combination treatment with sildenafil may be a possible efficient alternative when single oral or local treatment has failed. Intraurethral alprostadil can be administered in all patients irrespective of ED origin and should be the first option in patients with ED for whom therapy with PDE5 inhibitors has failed or is contraindicated. PMID:23170913

Costa, Pierre; Potempa, Axel-Juerg

2012-12-01

113

Avanafil: a review of its use in patients with erectile dysfunction.  

PubMed

Avanafil (STENDRA™, SPEDRA™, Zepeeed™) is an oral phosphodiesterase type 5 inhibitor indicated for the treatment of erectile dysfunction. Avanafil is rapidly absorbed after oral administration, with a median time to maximum plasma concentration of 30 to 45 min. In a 12-week, randomized, double-blind, placebo-controlled, multicentre trial in patients with erectile dysfunction, avanafil 50, 100 and 200 mg recipients had significantly greater improvements from baseline than placebo recipients in mean international index of erectile dysfunction-erectile function domain scores and in successful vaginal penetration and sexual intercourse attempts (coprimary endpoints). Treatment effects were significantly larger in avanafil 100 and 200 mg recipients than 50 mg recipients. For avanafil recipients, approximately two-thirds of attempts at sexual intercourse that were made prior to 15 min, or more than 6 h, after drug administration were successful, compared with approximately one-quarter of attempts made during these time periods by placebo recipients. In trials in patients with erectile dysfunction in association with diabetes mellitus, and after nerve-sparing radical prostatectomy, avanafil 100 or 200 mg was significantly more efficacious than placebo for primary and most secondary endpoints. Avanafil was generally well tolerated in the above-mentioned studies. In a pooled analysis of three clinical trials, ?2 % of avanafil and placebo recipients discontinued treatment because of adverse events. During extended treatment with avanafil for >52 weeks, 2.8 % of patients discontinued treatment because of adverse reactions and there were no drug-related serious adverse events. PMID:23955441

Sanford, Mark

2013-10-01

114

The Psychological and Interpersonal Relationship Scales: Assessing Psychological and Relationship Outcomes Associated with Erectile Dysfunction and Its Treatment  

Microsoft Academic Search

Erectile dysfunction (ED) is associated with complex psychological and interpersonal issues. A new measure of treatment outcome, the Psychological and Interpersonal Relationship Scales (PAIRS), was developed to evaluate the broader psychological and interpersonal outcomes associated with erectile dysfunction and its treatment. Initial items were generated based on literature review, focus groups and market research, interviews with patients and partners, and

Ralph W. Swindle; Ann E. Cameron; Daniel C. Lockhart; Raymond C. Rosen

2004-01-01

115

Apoptosis and Effects of Intracavernous Bone Marrow Cell Injection in a Rat Model of Postprostatectomy Erectile Dysfunction  

Microsoft Academic Search

ObjectivesTo investigate the pathophysiology of postprostatectomy erectile dysfunction (pPED) in a rat model of bilateral cavernous nerve ablation (BCNA) and to assess the effects of local bone marrow mononuclear cell (BMMNC) injection on erectile dysfunction (ED) and cavernosal cellular abnormalities caused by BCNA.

Papa Ahmed Fall; Mohamed Izikki; Li Tu; Salem Swieb; Francois Giuliano; Jacques Bernabe; Rachid Souktani; Claude Abbou; Serge Adnot; Saadia Eddahibi; René Yiou

2009-01-01

116

Prevalence of erectile dysfunction and its correlates: a population-based study in Morocco  

Microsoft Academic Search

To obtain data on the prevalence of erectile dysfunction (ED) and its correlates, along with help-seeking behaviour, 655 randomly selected men at least 25 y old, residing in Casablanca, Morocco, were recruited. They responded to a questionnaire administered by five trained sociologist interviewers. Information on demographics, concomitant diseases, drugs, and sexual activity was collected. ED was prevalent in 54%, increased

S Berrada; N Kadri; S Mechakra-Tahiri; C Nejjari

2003-01-01

117

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

118

Prevalence and Risk Factors of Erectile Dysfunction in Iranian Diabetic Men  

Microsoft Academic Search

Erectile dysfunction (ED) is an important impediment to quality of life. Diabetes mellitus is one of the most common causes of ED. However, it has been one of the most neglected complications of diabe tes mellitus. Our objective was to study the prevalence of ED and its risk factors in Iranian diabetic men . During 2002-2004, 700 diabetic men aged

Alireza Mofid; Seyed Ahmad Seyedalinaghi; Saeed Zandieh; Tahereh Yazdani; Sara Jam

119

Clinical efficacy of Apomorphine SL in erectile dysfunction of diabetic men  

Microsoft Academic Search

Although subgroup analyses from large randomised premarketing studies have shown that Apomorphine SL enhances the percentage of erections firm enough for sexual intercourse in diabetic men, the clinical role of the drug in this patient population remains to be elucidated. The aim of the present study was to assess the efficacy of Apomorphine SL in diabetic males with erectile dysfunction

P Gontero; R D'Antonio; G Pretti; F Fontana; M Panella; E Kocjancic; G Allochis; B Frea

2005-01-01

120

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

Microsoft Academic Search

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

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

2001-01-01

121

Hypogonadism in men with erectile dysfunction may be related to a host of chronic illnesses  

Microsoft Academic Search

The prevalence of hypogonadism has been found to be increased in certain chronic illnesses, especially diabetes, hypertension and obesity. Recently, the prevalence of hypogonadism in primary care practices mirrored that in our population of men with erectile dysfunction (ED). In this study, the prevalence of hypogonadism in nearly 1000 men with ED was tabulated, using a retrospective chart review, and

A Guay; A D Seftel; A Traish

2010-01-01

122

Sildenafil: from angina to erectile dysfunction to pulmonary hypertension and beyond  

Microsoft Academic Search

In less than 20 years, the first selective type 5 phosphodiesterase inhibitor, sildenafil, has evolved from a potential anti-angina drug to an on-demand oral treatment for erectile dysfunction (Viagra), and more recently to a new orally active treatment for pulmonary hypertension (Revatio). Here we describe the key milestones in the development of sildenafil for these diverse medical conditions, discuss the

Ian H. Osterloh; Friedrich Grimminger; Hossein A. Ghofrani

2006-01-01

123

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

Microsoft Academic Search

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

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

2000-01-01

124

Reactive oxygen species and erectile dysfunction: possible role of NADPH oxidase  

Microsoft Academic Search

Erectile dysfunction (ED) is a widespread condition, the incidence of which is increasing globally. ED is also indicative of underlying vasculopathy and represents a predictor of more serious cardiovascular disorders. Understanding the aetiology of ED may therefore provide invaluable pointers to the pathobiology of other cardiovascular diseases (CVDs) and syndromes. It follows, too, that therapeutic interventions that are successful in

J Y Jeremy; R A Jones; A J Koupparis; M Hotston; R Persad; G D Angelini; N Shukla

2007-01-01

125

Socioeconomic factors and incidence of erectile dysfunction: findings of the longitudinal Massachussetts Male Aging Study  

Microsoft Academic Search

Despite the well-documented relationship of socioeconomic factors (SEF) to various health problems, the relationship of SEF to erectile dysfunction (ED) is not well understood. As such, the goals of this paper are: (1) to determine whether incident ED is more likely to occur among men with low SEF; and (2) to determine whether incident ED varies by SEF after taking

Isik A. Aytaç; Andre B. Araujo; Catherine B. Johannes; Ken P. Kleinman; John B. McKinlay

2000-01-01

126

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

Microsoft Academic Search

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

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

1998-01-01

127

Erectile dysfunction: prevalence and associated variables in patients with chronic renal failure  

Microsoft Academic Search

Patients with chronic renal failure (CRF) experience a significant decrease in quality of life, due both to the limitations imposed by the disease as well as the demands of the treatment that they receive. Some side effects of both illness and treatment contribute to increase the morbidity of these patients. Among them, erectile dysfunction (ED) is notbl One hundred and

J Cerqueira; M Moraes; S Glina

2002-01-01

128

The false organic–psychogenic distinction and related problems in the classification of erectile dysfunction  

Microsoft Academic Search

The traditional distinction between organic and psychogenic erectile dysfunction (ED) was maintained in the recent report of the Nomenclature Committee of the International Society for Sexual and Impotence Research. Among the major problems with this distinction are that it is based on an obsolete view of mind–body distinctions, does not take into account knowledge of the neurobiology of ‘psychological’ disorders,

Benjamin D Sachs

2003-01-01

129

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

130

Do vardenafil and tadalafil have advantages over sildenafil in the treatment of erectile dysfunction?  

Microsoft Academic Search

Erectile dysfunction (ED) affects up to 50% of men between the ages of 40 and 70 years of age. Sildenafil, vardenafil and tadalafil have all been shown to be similarly effective in the treatment of men with ED of vary etiologies, to have similar adverse effects profiles, and to improve quality-of-life by similar amounts. As these phosphodiesterase 5 (PDE5) inhibitors

S Doggrell

2007-01-01

131

Attitudes of Men with Erectile Dysfunction: A Cross-National Survey  

Microsoft Academic Search

Introduction. Erectile dysfunction (ED), the inability to achieve or maintain an erection sufficient for sexual performance, is a complex disorder involving multiple biopsychosocial factors. Aim. To better understand the psychological and behavioral aspects of ED and compare the attitudes of ED patients in different countries. Methods. The Cross-National Survey on Male Health Issues surveyed men aged 20-75 years in six

Michael Perelman; Ridwan Shabsigh; Allen Seftel; Stanley Althof; Dan Lockhart

2005-01-01

132

Progesterone reduces erectile dysfunction in sleep-deprived spontaneously hypertensive rats  

Microsoft Academic Search

BACKGROUND: Paradoxical sleep deprivation (PSD) associated with cocaine has been shown to enhance genital reflexes (penile erection-PE and ejaculation-EJ) in Wistar rats. Since hypertension predisposes males to erectile dysfunction, the aim of the present study was to investigate the effects of PSD on genital reflexes in the spontaneously hypertensive rat (SHR) compared to the Wistar strain. We also extended our

Monica L Andersen; Raquel CS Martins; Tathiana AF Alvarenga; Isabela B Antunes; Ligia A Papale; Sergio Tufik

2007-01-01

133

ORAL TRAZODONE IS NOT EFFECTIVE THERAPY FOR ERECTILE DYSFUNCTION: A DOUBLE-BLIND, PLACEBO CONTROLLED TRIAL  

Microsoft Academic Search

PurposeThe unusual side effect of priapism associated with the antidepressant trazodone has led researchers to evaluate its use for the treatment of erectile dysfunction. Previous studies have shown nearly 70% efficacy in patients. Unfortunately, these studies have been anecdotal, retrospective or of combination therapy with yohimbine. A placebo controlled, fixed dose, double-blind crossover study was performed to evaluate the safety

RAYMOND A. COSTABILE; MARIANNE SPEVAK

1999-01-01

134

Yohimbine in erectile dysfunction: would an orphan drug ever be properly assessed?  

Microsoft Academic Search

The systemic use of adrenergic antagonists in the treatment of sexual dysfunction has originated more controversy than results.\\u000a Among the various agents, yohimbine has acquired an unenviable reputation in the treatment of erectile dysfunction. The drug\\u000a is pharmacologically well characterized as an ?2 adrenoceptor antagonist with activity in the central and peripheral nervous systems. In-depth, systematic studies in animals\\u000a have

Alvaro Morales

2001-01-01

135

Erectile dysfunction occurs following substantia nigra lesions in the rat  

Microsoft Academic Search

Erectile function was assessed 6 weeks following uni- and bilateral injections of 6-hydroxydopamine in the substantia nigra nucleus of the brain. Behavioral apomorphine-induced penile erections were reduced (5\\/8) and increased (3\\/8) in uni- and bilateral lesioned animals. Intracavernous pressures, following electrical stimulation of the cavernous nerve, decreased in lesioned animals. Lesions of the substantia nigra were confirmed by histology. Concentration

AR Zahran; N Simmerman; S Carrier; P Vachon

2001-01-01

136

Male erectile dysfunction following spinal cord injury: a systematic review  

Microsoft Academic Search

Study design:Systematic review.Objective:To review sexuality in persons with spinal cord injuries (SCIs), and to report the effectiveness of erectile interventions.Methods:Reports from six databases (1966–2003), selected annual proceedings (1997–2002) and manufacturer's information were screened against eligibility criteria. Included reports were abstracted and data pooled from case-series reports regarding intracavernous injections and sildenafil.Results:From 2127 unique reports evaluated, 49 were included. Male sexual

D DeForge; J Blackmer; C Garritty; F Yazdi; V Cronin; N Barrowman; M Fang; V Mamaladze; L Zhang; M Sampson; D Moher

2006-01-01

137

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.

2013-01-01

138

Preliminary observations of sildenafil treatment for erectile dysfunction in dialysis patients.  

PubMed

Erectile dysfunction is common in dialysis patients. We report our experience with sildenafil citrate in patients undergoing dialysis therapy. Male subjects attending the Outpatient Dialysis Unit at the University of Pennsylvania (Philadelphia, PA) who were prescribed sildenafil by their primary physician or nephrologist were asked to complete the International Index of Erectile Function before their first dose of sildenafil and after at least 4 weeks of therapy. Subjects' mean age was 50.3 +/- 14.63 (SD) years. Ninety-three percent of the subjects were black. Based on a global efficacy question, 66.7% of the subjects believed that treatment had improved their erections. Subjects reported no increase in the sexual desire domain despite experiencing a significant increase in erectile function, orgasmic function, and satisfaction with intercourse. Sildenafil was well tolerated in a selected group of patients who reported improved sexual function with no major adverse effects. PMID:11136178

Rosas, S E; Wasserstein, A; Kobrin, S; Feldman, H I

2001-01-01

139

Influence of socio-demographic characteristics on prevalence of erectile dysfunction in Nigeria.  

PubMed

Data on erectile dysfunction (ED) in Nigeria are limited. The study determined the influence of socio-demographic characteristics on ED prevalence in Ilorin, Nigeria. A sample of 399 married men aged 20-70 years was taken. They responded to a questionnaire adapted to reflect the local cultures. Data on socio-demographic characteristics, current use of penile erectile enhancers and erectile function were obtained. Erectile function was assessed using the abridged five-item version of the International Index of Erectile Function (IIEF-5). Presence of ED was defined as IIEF-5 score of <21. Descriptive and test statistics were applied to the quantitative data. The results revealed ED prevalence of 46.9% with 34.3, 9.8 and 2.8% having mild, moderate and severe ED, respectively. Men aged 40-64 years, reported severe ED from 9.1 to 36.4%. Yoruba ethnic group had the highest ED prevalence. Of the variables, age, length of marriage and spousal status were significantly associated and correlated with ED (P<0.05), while ethnicity, religion and age at first marriage were not (P>0.05). With an aging population, ED may become a significant health problem in similar environments in Nigeria. PMID:22895099

Oladiji, F; Kayode, O O; Parakoyi, D B

2012-08-16

140

DOUBLE-BLIND MULTICENTER STUDY COMPARING ALPROSTADIL ?-CYCLODEXTRIN WITH MOXISYLYTE CHLORHYDRATE IN PATIENTS WITH CHRONIC ERECTILE DYSFUNCTION  

Microsoft Academic Search

PurposeWe compared the efficacy and safety of alprostadil alpha-cyclodextrin and moxisylyte chlorhydrate to induce erections adequate for sexual intercourse in a prospective, randomized, parallel double-blind study in patients with erectile dysfunction.

Jacques Buvat; Pierre Costa; Dominique Morlier; Brigitte Lecocq; Barbara Stegmann; Detlef Albrecht

1998-01-01

141

Topical alprostadil cream for the treatment of erectile dysfunction: a combined analysis of the phase II program  

Microsoft Academic Search

ObjectivesTo present a meta-analysis of the efficacy and safety data of two recently completed Phase II studies examining a novel alprostadil topical cream for the treatment of erectile dysfunction (ED).

Christopher Steidle; Harin Padma-Nathan; Shawki Salem; Natalie Tayse; Denise Thwing; Jane Fendl; James Yeager; Ronald Harning

2002-01-01

142

Treatment Options for Male Erectile Dysfunction: A Systematic Review of Published Studies of Effectiveness. Technology Assessment Program.  

National Technical Information Service (NTIS)

This report was written in response to a request to Veteran's Administration's (VA's) Technology Recommendations Panel (TRP) regarding treatment options for male erectile dysfunction (ED). The TRP, a national committee, is 'responsible for the evaluation ...

T. J. Wilt H. A. Fink R. MacDonald I. R. Rutks D. Schow

1999-01-01

143

Rehabilitation of the cavernous smooth muscle in patients with organic erectile dysfunction.  

PubMed

This study aimed at assessing the effect of regular use of intracorporeal injection (ICI), sildenafil citrate and vacuum constriction device (VCD) on cavernous smooth muscle and erectile activity. One hundred and sixty-five patients with organic erectile dysfunction were investigated for 3 months. The patient and his partner were classified prospectively after proper counselling: group I (n = 56) received ICI twice per week; group II (n = 55) received sildenafil 100 mg twice per week; and group III (n = 54) used VCD twice per week. Duplex ultrasound was carried out before and after treatment, and then, the patients were followed up for a month to assess the resumption of unaided erection. The results showed that there was significant improvement in mean peak systolic velocity (PSV) and mean cavernosal artery diameter (CAD) at the end of the treatment in all groups, being higher in the ICI group than in the other two groups. Also, the percentage of patients who resumed unaided intercourse were higher in the ICI group compared with the other two groups (17.9%, 9.1% and 3.7% respectively). It is concluded that repeated regular use of ICI, sildenafil or VCD by patients with organic erectile dysfunction has a positive impact on their cavernous blood flow and erectile activity. PMID:21592173

Salem, H; Mostafa, T

2011-05-19

144

Intracavernous alprostadil alfadex (EDEX\\/VIRIDAL) is effective and safe in patients with erectile dysfunction after failing sildenafil (Viagra)  

Microsoft Academic Search

Objectives. Sildenafil (Viagra), an oral treatment for erectile dysfunction, has proved popular since its introduction in 1998. However, not all patients respond to this form of therapy. Consequently, this study investigated the efficacy of intracavernous alprostadil alfadex (EDEX\\/VIRIDAL) treatment in patients not responding to sildenafil.Methods. In an open-label, multicenter study, patients with erectile dysfunction were treated with sildenafil for 4

R Shabsigh; H Padma-Nathan; M Gittleman; J McMurray; J Kaufman; I Goldstein

2000-01-01

145

Noninvasive treatment for erectile dysfunction in the neurogenically disabled population  

Microsoft Academic Search

Erictile 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,

Ronit Aloni; Leon Heller; Ofer Keren; Eliezer Mendelson; Gary Davidoff

1992-01-01

146

Erectile dysfunction precedes coronary artery endothelial dysfunction in rats fed a high-fat, high-sucrose, Western pattern diet.  

PubMed

Introduction.? It is suggested that erectile dysfunction (ED) may be an early risk factor for cardiovascular disease. Aim.? The goal of this study was to determine whether development of ED precedes the onset of coronary artery endothelial dysfunction in response to a Western diet (WD), thereby establishing whether the WD differentially impacts the endothelium in a time-dependent manner. Additionally, a goal was to determine if diet-induced ED is reversible with intracavernosal sepiapterin treatment. Methods.? Male Sprague-Dawley rats were fed a WD for 4, 8, or 12 weeks, or a control diet for 8 weeks. Erectile function was evaluated by measuring the mean arterial pressure (MAP) and intracavernosal pressure (ICP) in response to electrical field stimulation of the cavernosal nerve near the major pelvic ganglion, in the absence and presence of sepiapterin. Coronary artery endothelial function was evaluated ex vivo with cumulative doses of acetylcholine (ACh) applied to segments of the left anterior descending coronary artery preconstricted with serotonin. Main Outcome Measures.? Erectile function was assessed as the ICP response to electrical field stimulation (EFS), normalized to MAP. Coronary artery endothelial function was assessed as the effective concentration producing 50% of a maximal response (EC50 ) of the ACh response. Results.? The ICP/MAP response to EFS was significantly attenuated following both 8 and 12 weeks of the WD compared with the control diet (P?erectile function is reduced prior to coronary artery endothelial function in response to the WD. Improvement of erectile function with sepiapterin in WD rats indicates that nitric oxide synthase uncoupling is a key mechanism in diet-induced ED. La Favor JD, Anderson EJ, Hickner RC, and Wingard CJ. Erectile dysfunction precedes coronary artery endothelial dysfunction in rats fed a high-fat, high-sucrose, Western pattern diet. J Sex Med 2013;10:694-703. PMID:23170997

La Favor, Justin D; Anderson, Ethan J; Hickner, Robert C; Wingard, Christopher J

2012-11-21

147

Correlation between Serum Total Testosterone and the AMS and IIEF Questionnaires in Patients with Erectile Dysfunction with Testosterone Deficiency Syndrome  

PubMed Central

Purpose This study was conducted to investigate the relationship between serum total testosterone levels and scores on the Aging Male's Symptom (AMS) scale and the International Index of Erectile Function (IIEF) in men with erectile dysfunction with testosterone deficiency syndrome (TDS). Materials and Methods From January 2005 to July 2008, 134 patients who complained of sexual dysfunction such as erectile dysfunction or decreased libido as the main symptoms of TDS with serum total testosterone levels less than 3.5 ng/ml were evaluated by independent t-test and linear regression analysis, respectively. Patients with treated hypogonadism within 6 months, with a history of taking a PDE5 inhibitor or an antidepressant for a depressive disorder, or who had metabolic syndrome were excluded from this study. Results The AMS scale and its 3 subdomain scores were not significantly correlated with the total testosterone level. By contrast, the total IIEF score and the score of each IIEF domain except sexual desire showed a weakly significantly positive correlation with serum total testosterone. Conclusions In TDS patients with erectile dysfunction, there was a low relationship between serum total testosterone levels and the AMS scale and a weakly positive correlation between total testosterone levels and all IIEF domains except sexual desire. There was a low relationship between the AMS scale, the sexual desire domain score of the IIEF, and total testosterone. We should understand these limitations when evaluating patients with erectile dysfunction with TDS. New scales should be developed for the evaluation of erectile dysfunction in these patients.

Kang, Jae Il; Ham, Byeong Kuk; Oh, Mi Mi; Kim, Je Jong

2011-01-01

148

Prevalence of erectile dysfunction in men with ischemic heart disease in a tertiary hospital in malaysia.  

PubMed

We report a study which defined the prevalence of erectile dysfunction (ED) among men with ischaemic heart disease. We recruited 510 men with established ischemic heart disease and interviewed these men using the International Index of Erectile Dysfunction (IIEF-5) questionnaire to determine the presence and severity of ED. Presence of ED was defined as IIEF-5 score of less than 22. The mean age was 60.5 years (range 36-92 years; SD: +9.58). 461 (90.4%) men reported some degree of ED of which two third of them had moderate to severe ED. The prevalence of ED increased significantly with age. Age above 60 years was the only significant risk factor. Non-statistically significant but important risk factors included diabetes, hypertension, diuretics and oral hypoglycemic agents. ED is very common among men with ischemic heart disease. The prevalence and severity increased significantly with age above 60 years old. PMID:24145256

Koh, K C

2013-08-01

149

Efficacy and Safety of Sildenafil in Asian Males with Erectile Dysfunction and Cardiovascular Risk  

Microsoft Academic Search

Objective: Assess the effectiveness of sildenafil in Asian males with erectile dysfunction (ED) and one or more of the co-morbidities, mild-to-moderate hypertension, dyslipidemia, and diabetes. Material and Method: A six-week, double-blind, randomized, placebo-controlled, multicenter study was carried out in Thailand, Malaysia and Singapore One hundred and fifty five male subjects were randomized (2:1) to sildenafil (n = 104) or placebo

Peera Buranakitjaroen; Ampica Mangklabruks

2007-01-01

150

Effects of sildenafil on blood pressure in hypertensive patients with erectile dysfunction  

Microsoft Academic Search

Erectile dysfunction (ED) is common among hypertensive men, associated to hypertension itself and\\/or as a consequence of antihypertensive treatment. Accordingly, we evaluated the efficacy and safety of Sildenafil (PDE5 inhibitor) and its effects on blood pressure (BP) in hypertensive men with ED. We studied 23 men with previously-diagnosed essential hypertension, 55±6 (mean±SD) years of age, receiving 1-2 drugs for hypertension,

C. Calvo; J. E. López; M. Covelo; M. J Dom??nguez; C Mart??nez; D. E. Ayala; R. C. Hermida

2001-01-01

151

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

Microsoft Academic Search

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

Marvin M. Goldenberg

1998-01-01

152

Efficacy and safety of sildenafil in hypertensive patients with erectile dysfunction  

Microsoft Academic Search

Erectile dysfunction (ED) is common among hypertensive men, associated to hypertension itself and\\/or as a consequence of antihypertensive treatment. Accordingly, we evaluated the efficacy and safety of Sildenafil (PDE5 inhibitor) administered to hypertensive men with ED. We studied 52 >18-year men with previously-diagnosed essential hypertension, 57.1 ± 9.5 years of age, with blood pressure (BP) below 160\\/100 mm Hg, and

P. Pérez-Leirós; M. Covelo; E. López; F. Gude; D. E. Ayala; R. C. Hermida

2000-01-01

153

Effects of pioglitazone on erectile dysfunction in sildenafil poor- responders: A randomized, controlled study  

Microsoft Academic Search

Purpose. The effects of pioglitazone on sildenafil responsiveness in men with erectile dysfunction (ED) and a history of poor response to sildenafil were assessed. Methods. In a double-blinded study, 38 men aged 47 ± 1.5 years with moderate-to- severe ED and poor response to sildenafil were randomly assigned to take a premedication of pioglitazone 30 mg (n=19) or placebo (n=19)

Babak Gholamine; Massoumeh Shafiei; Manijeh Motevallian; Massoud Mahmoudian

2008-01-01

154

How often do we ask about erectile dysfunction in the diabetes review clinic?  

Microsoft Academic Search

Diabetic neuropathy is a significant complication of chronic diabetes. We wished to discover whether we were successfully\\u000a identifying patients who had developed neuropathic problems. Specifically, Diabetologists are traditionally poor at asking\\u000a about erectile dysfunction (ED) and patients themselves are not always forthcoming as it an embarrassing medical problem.\\u000a We targeted all patients attending diabetes review clinics over a 4-month period

Paul S. Grant; David Lipscomb

2009-01-01

155

Lower urinary tract symptoms and erectile dysfunction: Epidemiology and treatment in the aging man  

Microsoft Academic Search

Lower urinary tract symptoms (LUTS) and erectile dysfunction (ED) are common urologic problems that are seen in the aging\\u000a male population. Until recently, aging itself was considered the common link between ED and LUTS. However, recent studies\\u000a have shown that the links between these two disease processes are much more complex and are possibly inter-related with a\\u000a common mechanism. This

Shane Russell; Kevin T. McVary

2005-01-01

156

A Review of the Pathophysiology and Novel Treatments for Erectile Dysfunction  

PubMed Central

Erectile dysfunction (ED) affects up to 50% of men between the ages of 40 and 70. Treatment with PDE-5 inhibitors is effective in the majority of men with ED. However, PDE-5 inhibitors are not effective when levels of nitric oxide (NO), the principle mediator of erection, are low. The pharmacologic actions of three new potential treatments for ED are discussed in this paper: (1) sGC stimulators/activators, (2) Rho-kinase inhibitors, and (3) sodium nitrite.

Lasker, George F.; Maley, Jason H.; Kadowitz, Philip J.

2010-01-01

157

Practice patterns in the diagnosis and treatment of erectile dysfunction among family practice physicians  

Microsoft Academic Search

Objectives. To examine the philosophies and practices of the family practitioner (FP) regarding the diagnosis and treatment of erectile dysfunction (ED).Methods. A prospective study by questionnaire of a group of FPs was performed. The Spearman correlation coefficient and proportional odds regression analysis were used to measure the relationship between the continuous variable and ordinal-scale variables. The Goodman-Kruskal gamma test was

S. D Rutchik; M Baudiere; M Wade; G Sullivan; W Rayford; J Goodman

2001-01-01

158

Effects of yohimbine on sexual experiences and nocturnal penile tumescence and rigidity in erectile dysfunction  

Microsoft Academic Search

The therapeutic effect of the ?2-antagonist yohimbine in erectile dysfunction was studied in a double-blind placebo-controlled design. Thirty-one male patients\\u000a underwent extensive clinical, urological, and psychiatric diagnosis and were dichotomically classified into an organic and\\u000a a nonorganic subgroup. Following a 1-week placebo run-in period, patients were randomly assigned to a placebo or a verum group\\u000a (yohimbine 15 mg daily) for

Klaus Mann; Thomas Klingler; Susanne Noe; Joachim Röschke; Stefan Müller; Otto Benkert

1996-01-01

159

Central nervous system agents in the treatment of erectile dysfunction: How do they work?  

Microsoft Academic Search

Drugs acting within the central nervous system (CNS) that reduce the sympathetic antierectile flow and enhance the parasympathetic\\u000a proerectile flow to the penis may restore penile erection in cases of erectile dysfunction of both psychogenic and organic\\u000a origin. The best characterized of such drugs is the dopaminergic agonist apomorphine, which acts on the hypothalamus and,\\u000a perhaps, the autonomic nuclei in

Julien Allard; Francois Giuliano

2001-01-01

160

A dose-response study of alprostadil in patients with erectile dysfunction  

Microsoft Academic Search

The efficacy and safety of alprostadil were investigated in this open-label study of 105 men with various etiologies of erectile dysfunction (ED). Initially, patients received an intracavernous injection of alprostadil 2.5 ?g, with subsequent increases in dose until a full erection (lasting 30 to 60 minutes) was achieved or a dose of 40 ?g was reached. Ninety-eight (96.1%) of the

Telesforo E. Gana; Luis F. Quizanos; Raul Castell; Jose D. Dator; Eduardo R. Gatchalian; Guerilio U. Lim

1996-01-01

161

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

Microsoft Academic Search

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

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

2001-01-01

162

Safety and Efficacy of Alprostadil Sterile Powder (S. Po., CAVERJECT®) in Diabetic Patients with Erectile Dysfunction  

Microsoft Academic Search

Objectives: To evaluate the long–term efficacy and safety of intracavernosal alprostadil (CAVERJECT®) in diabetic patients with erectile dysfunction (ED).Patients and Methods: This study included 31 diabetic men (aged 44–75 years) with ED of ?4 months duration. All patients were initially instructed in the self–injection technique at the investigator’s clinic. The optimal dose was determined for each patient and set at

2000-01-01

163

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

Microsoft Academic Search

This qualitative study aimed to examine cultural differences in knowledge, attitudes and practices related to erectile dysfunction (ED) utilizing focus group discussion. Six focus groups consisting of 66 men, 45–70-y-old were conducted—two Malay groups (n=18), two Chinese groups (n=25) and two Indian groups (n=23). Participants were purposively recruited from the general public on a voluntary basis with informed consent. Transcripts

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

2002-01-01

164

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

Microsoft Academic Search

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

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

2001-01-01

165

Gene Therapy of Erectile Dysfunction in the Rat with Penile Neuronal Nitric Oxide Synthase1  

Microsoft Academic Search

Gene transfer to the penile corpora cavernosa of constructs of the inducible and endothelial nitric oxide synthase (NOS) cDNAs ameliorates erectile dysfunction in aged rats. In this study, we investigated whether the neuronal NOS (nNOS) var- iant responsible for erection, penile nNOS (PnNOS), can exert a similar effect, and whether the combination of electroporation with a helper-dependent adenovirus (AdV) improves

Thomas R. Magee; Monica Ferrini; Hermes J. Garban; Dolores Vernet; Kohnosuke Mitani; Jacob Rajfer; Nestor F. Gonzalez-Cadavid

166

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

PubMed

Sildenafil citrate has been shown to be effective in a wide range of patients with erectile dysfunction and has been approved in the United States for this indication. The overall clinical safety of oral sildenafil, a potent inhibitor of phosphodiesterase type 5, in the treatment of erectile dysfunction was evaluated in more than 3700 patients (with a total of 1631 years of exposure worldwide). Safety and tolerability data were analysed from a series of double-blind, placebo-controlled studies and from 10 open-label extension studies of sildenafil in the treatment of erectile dysfunction. A total of 4274 patients (2722 sildenafil, 1552 placebo; age range 19-87 y) received double-blind treatment over a period of up to six months' duration, and 2199 received long-term, open-label sildenafil for up to 1 y. The most commonly reported adverse events (all causes) were headache (16% sildenafil, 4% placebo), flushing (10% sildenafil, 1% placebo), and dyspepsia (7% sildenafil, 2% placebo) and they were predominantly transient and mild or moderate in nature. These adverse events reflect the pharmacology of sildenafil as a phosphodiesterase type 5 inhibitor. No cases of priapism were reported. The rate of discontinuation due to adverse events (all causes) was comparable for patients treated with sildenafil (2.5%) and placebo (2.3%). In open-label extension studies, 90% of patients completed long-term sildenafil treatment, with only 2% withdrawing due to adverse events. Sildenafil is a well-tolerated oral treatment for erectile dysfunction. PMID:9647940

Morales, A; Gingell, C; Collins, M; Wicker, P A; Osterloh, I H

1998-06-01

167

Erectile dysfunction, depression, and pharmacological treatments: biologic interactions  

Microsoft Academic Search

\\u000a Sexual dysfunctions are common, in general, and especially prevalent among patients with psychiatric disorders. Male sexual\\u000a dysfunction is associated with a range of imputed neurobiological, medical, psychological and interpersonal causes, and can\\u000a have a significant impact on interpersonal functioning and quality of life. Moreover, the interaction between co-morbid sexual\\u000a and psychiatric disorders has clinical implications for diagnosis, course, and treatment

Stuart N. Seidman

168

[Non-arteritic anterior ischemic optic neuropathy associated with erectile dysfunction medications].  

PubMed

Erectile dysfunction medications such as sildenafil citrate (Viagra) or tadalafil (Cialis) are commonly prescribed worldwide. They are selective phosphodiesterase-5 inhibitor and partial phosphodiesterase-6 inhibitors causing smooth muscle relaxation in the corpus cavernosum, allowing penile vasodilatation and erection in response to sexual stimuli. Over the years, there have been an increasing number of case reports concerning patients who developed ischemic optic neuropathy soon after the ingestion of these drugs. Although a cause and effect relationship between usage of the drugs and the development of ischemic optic neuropathy is difficult to prove, it is common nowadays to advise patients, especially those suffering from diabetes, hypertension, and ischemic heart disease, regarding the potential risk of visual loss due to ischemic optic neuropathy and treatment with erectile dysfunction drugs. Patients who were diagnosed with ischemic optic neuropathy soon after the ingestion of these erectile dysfunction drugs should be warned about a similar event in their fellow eye and should be advised regarding drug discontinuation. PMID:23513498

Krashin-Bichler, Iris; Dotan, Gad

2013-02-01

169

Antidepressant-related erectile dysfunction: management via avoidance, switching antidepressants, antidotes, and adaptation.  

PubMed

The ideal antidepressant would control depression with no adverse effect on sexual function. Erectile dysfunction 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 computerized MEDLINE search (English language, 1966-2003) was performed using the terms antidepressive agents, erectile dysfunction, and sexual dysfunction. Emphasis was placed on studies with specific sexual function measurements taken before and after treatment and placebo control. Mixed mediator, nonserotonergic antidepressants that block postsynaptic serotonin type 2 receptors (nefazodone, mirtazapine) or that primarily increase dopamine or norepinephrine levels (bupropion) were thought to be good choices for avoiding antidepressant-associated sexual dysfunction or for switching patients in whom antidepressant-associated sexual dysfunction emerged. Comparisons with serotonin reuptake inhibitors (SRIs) have revealed less desire and orgasm dysfunction with nonserotonergic bupropion, less orgasm dysfunction with nefazodone, and superior overall satisfaction with sexual functioning with bupropion or nefazodone. However, most of these studies have design flaws that make evidence-based claims of efficacy difficult to substantiate. Agents proposed for antidote use in antidepressant-associated sexual dysfunction have either not been studied in men or not proved efficacious in randomized placebo-controlled trials. Switching to and augmentation with bupropion or nefazodone have also not clearly shown efficacy in controlled trials and require care and monitoring to avoid SRI discontinuation symptoms and loss of antidepressant efficacy. Few proposed treatment options, apart from avoidance, have proved effective for antidepressant-associated sexual dysfunction, which can have negative consequences on depression management. PMID:12971811

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

2003-01-01

170

Distress: associated variables of erectile dysfunction post-acute myocardial infarction. A pilot study.  

PubMed

This study aimed to identify the associated variables of erectile dysfunction (ED) in post myocardial infarction (MI) patients without previous sexual dysfunction (SD). Out of the 37 patients, 15 (40%) had ED. Patients significantly reduced the frequency of coitus (P<0.05). Out of nine patients with distress, eight presented ED, and of 28 patients without distress, seven presented ED (89 versus 25%, P=0.001). The two groups (distress versus without distress) were similar regarding confounding variables. We concluded that patients without SD prior the MI had a significant incidence of ED and distress was an associated variable of ED post-infarction. PMID:15538397

Vacanti, L; Caramelli, B

171

Etiological attributions, responsibility attributions, and marital adjustment in erectile dysfunction patients.  

PubMed

The relationships between responsibility attributions, etiological attributions (psychogenically versus biogenically caused), and marital adjustment were explored in 30 erectile dysfunction patients and their partners via the Attributions Regarding Sexual Dysfunction Questionnaire and the Dyadic Adjustment Scale. Exploration of responsibility attributions yielded a consistent pattern of blaming the identified patient. This pattern is discussed in terms of two perspectives in attributional theory: the "self-serving bias" and the "just world" hypothesis. Etiological attributions were not relevant to actual diagnosis, marital adjustment, choice of treatment professional, or expectations for treatment outcome. Partner agreement regarding etiology was not related to actual cause or marital adjustment. PMID:1640476

Simkins-Bullock, J; Wildman, B G; Bullock, W A; Sugrue, D P

1992-01-01

172

Efficacy of tadalafil in Egyptian and Turkish men with erectile dysfunction  

PubMed Central

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

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

2006-01-01

173

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

174

Use of intracavernous injection of prostaglandin E1 for neuropathic erectile dysfunction.  

PubMed

The administration and suitability of intracavernous PGE-1 in men with neuropathic erectile dysfunction is reported herein. Twenty-seven men with neuropathic erectile dysfunction (SCI, 14; multiple sclerosis, 7; discogenic disease, 6) were evaluated and treated with intracavernous PGE-1. An average of 3.2 office sessions were required to learn adequate self-injection technique and determine optimal dosage requirement. Initial dosage for SCI men was 2.5 micrograms and increased in 2.5 micrograms increments to a mean maintenance dose of 6.2 micrograms. Quarterly monitoring up to 28 months demonstrated satisfactory erectile rigidity and duration of erection in all patients electing to pursue home administration of PGE-1. During this interval, over 40% of patients dropped out of the treatment program. No priapism or changes in serum chemistries, CBC, or platelets were observed during this period. Corporal fibrosis although not palpable, was detected subclinically by penile ultrasound in two men. This study confirms the safety and efficacy of self-administered intracavernous PGE-1 for neuropathic impotence. However, because of a significant rate of voluntary cessation, patients should be counseled regarding the full range of therapeutic alternatives to intracavernous therapy. PMID:7831071

Hirsch, I H; Smith, R L; Chancellor, M B; Bagley, D H; Carsello, J; Staas, W E

1994-10-01

175

Self-Esteem, Confidence, and Relationships in Men Treated with Sildenafil Citrate for Erectile Dysfunction  

PubMed Central

BACKGROUND Men with erectile dysfunction (ED) often have low self-esteem, confidence, and sexual relationship satisfaction. OBJECTIVE We evaluated the impact of sildenafil citrate and its generalizability across cultures on self-esteem, confidence, and sexual relationship satisfaction in men with ED using the Self-Esteem And Relationship (SEAR) questionnaire. DESIGN Pooled analysis of 2 double-blind, placebo-controlled, flexible-dose trials of sildenafil with identical protocols: 1 was conducted in the United States and the other in Mexico, Brazil, Australia, and Japan. PATIENTS Men ?18 years old with ED. MEASUREMENTS The impact of treatment on psychosocial factors associated with ED was determined by patient responses to the SEAR questionnaire. Erectile function was determined using the International Index of Erectile Function (IIEF) and a global efficacy question. Successful sexual intercourse attempts were derived from event logs of sexual activity. Treatment effect sizes were calculated for all study outcomes. RESULTS Compared with patients who received placebo (n = 274), patients who received sildenafil (n = 279) reported significantly greater improvements (P<.0001) in self-esteem, confidence, sexual relationship satisfaction, and in all sexual function domains of the IIEF. Treatment effect sizes were large (range, 0.7 to 1.2) for all SEAR components, and improvement in psychosocial measures showed moderate to high correlations (range, 0.50 to 0.83, P<.0001) with improvement in erectile function, percentage of successful intercourse attempts, and global efficacy. CONCLUSIONS In men with ED from 5 different nations, sildenafil produced substantial improvements in self-esteem, confidence, and sexual relationship satisfaction. Improvements in these psychosocial factors were observed crossculturally and correlated significantly and tangibly with improvements in erectile function.

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

2006-01-01

176

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

PubMed

Patients with refractory angina often suffer from erectile dysfunction. Enhanced external counterpulsation (EECP) decreases symptoms of angina, and increases nitric oxide release. This study evaluated the effect of EECP on sexual function in men with severe angina. The International Index of Erectile Function (IIEF) was used to assess erectile function of severe angina patients enroled in the International EECP Patient Registry. Their symptom status, medication use, adverse clinical events and quality of life were also recorded before and after completing a course of EECP. A cohort of 120 men (mean age 65.0+/-9.7) was enroled. The men had severe coronary disease with 69% having a prior myocardial infarction, 90% prior coronary artery bypass graft or percutaneous coronary intervention, 49% with three vessel coronary artery disease, 86% were not candidates for further revascularisation, 71% hypertensive, 83% dyslipidaemia, 42% diabetes mellitus, 75% smoking and 68% using nitrates. Functional status was low with a mean Duke Activity Status Inventory score of 16.6+/-14.8. After 35 h of EECP anginal status improved in 89%, and functional status in 63%. A comparison of the IIEF scores pre- and post-EECP therapy demonstrated a significant improvement in erectile function from 10.0+/-1.0 to 11.8+/-1.0 (p=0.003), intercourse satisfaction (4.2+/-0.5 to 5.0+/-0.5, p=0.009) and overall satisfaction (4.7+/-0.3 to 5.3+/-0.3, p=0.001). However, there were no significant changes in orgasmic function (4.2+/-0.4 to 4.6+/-0.4, p=0.19) or sexual desire (5.3+/-0.2 to 5.5+/-0.2). The findings suggest that EECP therapy is associated with improvement in erectile function in men with refractory angina. PMID:17493089

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

2007-05-01

177

[Efficacy of phosphodiesterase inhibitors in the treatment of patients with organic erectile dysfunction: a comparative study].  

PubMed

Currently available three highly selective and effective PDE-5 inhibitors (sildenafil, tadalafil and wardenafil) are comparable by PDE-5 inhibition and selectivity of action on PDE-5 but their differences in activity, interaction with food and alcohol, biological half-life and other characteristics make their use individual for certain clinical situations. Our trial with participation of 575 patients (mean age 57.73 +/- 12.33 years) with arteriogenic erectile dysfunction and great number of vascular risk factors has shown that wardenafil was most popular among our examinees as it is more effective and begins acting faster. Further studies in optimization of the above drugs administration may perfect treatment of erectile dysfuncion. PMID:19432232

Mazo, E B; Gamidov, S I; Iremashvili, V V; Gasanov, R V

178

Efficacy and safety of sildenafil citrate in men with erectile dysfunction and chronic heart failure.  

PubMed

Chronic heart failure (CHF) is an increasingly common cardiovascular disorder. Many patients who have CHF report moderate to marked decreases in the frequency of sexual activity, and up to 75% of patients report erectile dysfunction (ED). There are few controlled clinical data on the efficacy and safety of sildenafil citrate in men who have ED and CHF; thus, we evaluated these parameters in patients who had stable CHF. This was a double-blind, placebo-controlled, flexible-dose study. Men who had ED and stable CHF were randomized to receive sildenafil or placebo for 12 weeks. Primary outcomes were questions 3 and 4 of the International Index of Erectile Function. Secondary outcomes included the 5 functional domains of the International Index of Erectile Function, 2 global efficacy assessment questions, intercourse success rate, the Erectile Dysfunction Inventory of Treatment Satisfaction, and the Life Satisfaction Checklist. By week 12, patients who received sildenafil (n = 60) showed significant improvements on questions 3 and 4 compared with patients who received placebo (n = 72; p <0.002). Larger percentages of patients who received sildenafil reported improved erections (74%) and improved intercourse (68%) compared with patients who received placebo (18% and 16%, respectively). Intercourse success rates were 53% among patients who received sildenafil and 20% among those who received placebo. Patients who received sildenafil were highly satisfied with treatment and their sexual life compared with patients who received placebo. Sixty percent of patients who received sildenafil and 48% of patients who received placebo developed adverse events, including transient headache, facial flushing, respiratory tract infection, and asthenia. The incidence of events related to cardiovascular effects was low. Sildenafil is an effective and well-tolerated management of ED in men who have mild to moderate CHF. PMID:15619391

Katz, Stuart D; Parker, John D; Glasser, Dale B; Bank, Alan J; Sherman, Nancy; Wang, Hao; Sweeney, Michael

2005-01-01

179

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

PubMed Central

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

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

2011-01-01

180

Long-term efficacy and compliance of intracorporeal (IC) injection for erectile dysfunction following radical prostatectomy: SHIM (IIEF-5) analysis  

Microsoft Academic Search

Baseline and follow-up data from 102 patients using intracorporeal (IC) injection for erectile dysfunction (ED) following RP were retrospectively collected. We compared baseline International Index for Erectile Function (IIEF) questionnaires with the abridged IIEF-5 questionnaires, referred to as the Sexual Health Inventory of Men (SHIM) to determine drug efficacy. The mean presurgery SHIM score was 21.75±5.23, which decreased to 4.23±3.48

R Raina; M M Lakin; M Thukral; A Agarwal; S Ausmundson; D K Montague; E Klein; C D Zippe

2003-01-01

181

Prevalence and risk factors of erectile dysfunction in Japanese men with type 2 diabetes.  

PubMed

This study aimed to elucidate the prevalence and clinical risk factors of erectile dysfunction (ED) in Japanese male diabetics. Questionnaires were administered to 82 male diabetics and 25 male non-diabetics (controls), to determine the international index of erectile function (IIEF). This index consists of five parts, with questions related to erectile function (EF), intercourse satisfaction (IS), orgasmic function (OF), sexual desire (SD), and overall satisfaction (OS). IIEF scores were compared between diabetics and controls, and were also analyzed in relation to clinical factors. Although EF, IS, and OF scores (physical factors) in diabetic men were significantly lower than those of age-matched controls, no significant differences were apparent in SD and OS scores (psychological factors). All patients with EF score > or = 18 reported being able to achieve sexual intercourse, we determined the criterion for ED as EF < 18. The prevalence of ED in diabetics and age-matched controls was 60% and 20%, respectively. EF score decreased with duration of diabetes and progression of retinopathy, proteinuria, ischemic heart disease, delayed nerve conduction, orthostatic intolerance, and attenuated heart rate variability. ED was found to be common in Japanese male diabetics. Possible influences of both microangiopathy and macroangiopathy on ED are suggested. PMID:15563972

Yamasaki, Hiroshi; Ogawa, Kenichi; Sasaki, Hideyuki; Nakao, Taisei; Wakasaki, Hisao; Matsumoto, Eisaku; Furuta, Hiroto; Nishi, Masahiro; Ueda, Kazuya; Iwo, Kazuhiro; Nanjo, Kishio

2004-12-01

182

Effects of male silkworm pupa powder on the erectile dysfunction by chronic ethanol consumption in rats  

PubMed Central

Erectile dysfunction (ED) is a highly prevalent disorder that affects millions of men worldwide. ED is now considered an early manifestation of atherosclerosis, and consequently, a precursor of systemic vascular disease. This study was designed to investigate the effects of male silkworm pupa powder (SWP) on the levels of nitric oxide synthase (NOS) expression, nitrite, and glutathione (GSH); lipid peroxidation; libido; and erectile response of the corpus cavernosum of the rat penis. We induced ED in the study animals by oral administration of 20% ethanol over 8 weeks. The SWP-treated male rats were divided into 3 groups that were orally administered 200, 400, and 800 mg/kg. The libido of the SWP-administered male rats was higher than that of the ethanol control group. In addition, the erectile response of the corpus cavernosum was restored in males on SWP administration, to a level similar to that of the normal group without ED. The testosterone concentration did not increase significantly. The lipid peroxidation in the corpus cavernosum of the male rats administered SWP decreased significantly. In contrast, compared to the ethanol group, SWP-administered male rats showed increased GSH levels in the corpus cavernosum. The level of nitrite and NOS expression in the corpus cavernosum of SWP-administered male rats increased significantly. These results indicated that SWP effectively restored ethanol-induced ED in male rats.

Oh, Hong-Geun; Lee, Hak-Yong; Kim, Jung-Hoon; Kang, Young-Rye; Moon, Dea-In; Seo, Min-Young; Back, Hyang-Im; Kim, Sun-Young; Oh, Mi-Ra; Park, Soo-Hyun; Kim, Min-Gul; Jeon, Ji-Young; Shin, Sook-Jeong; Ryu, Kang-Sun; Chae, Soo-Wan

2012-01-01

183

Large-scale questionnaire survey of erectile dysfunction drugs in Japanese men  

Microsoft Academic Search

Aim  The aim of the present study was to investigate the assessment of currently prescribed drugs and approaches to overall erectile\\u000a dysfunction (ED) therapy.\\u000a \\u000a \\u000a \\u000a Methods  A large-scale questionnaire survey was conducted in patients with ED who had taken an ED drug in the past 2 months.\\u000a \\u000a \\u000a \\u000a Results  Of the 308 patients surveyed, 23% became aware of having ED more than 3 years ago.

Koichi Nagao; Hideyuki Kobayashi; Koichi Nakajima; Masaharu Takanami; Kazukiyo Miura; Nobuhisa Ishii

2008-01-01

184

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

Microsoft Academic Search

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

Nikolaos Zias; Vishnu Bezwada; Sean Gilman; Alexandra Chroneou

2009-01-01

185

The use of vacuum erection devices in erectile dysfunction after radical prostatectomy.  

PubMed

The risk of postoperative erectile dysfunction (ED) following radical prostatectomy (RP) is reported to be between 14% and 89%. With an increase in the detection of prostate cancer in younger men, there is a greater emphasis on the appropriate management of ED following RP. A number of options are available to manage ED after RP, including phosphodiesterase-5 inhibitors, intracorporeal injections, intraurethral alprostadil, and vacuum erection devices (VEDs). Penile rehabilitation programs are increasingly used to facilitate the return of natural postoperative erections; the VED is an ideal therapy given that it increases blood flow and oxygenation to the corpora to reverse the changes that result in ED after RP. PMID:24082845

Hoyland, Kimberley; Vasdev, Nikhil; Adshead, James

2013-01-01

186

The Use of Vacuum Erection Devices in Erectile Dysfunction After Radical Prostatectomy  

PubMed Central

The risk of postoperative erectile dysfunction (ED) following radical prostatectomy (RP) is reported to be between 14% and 89%. With an increase in the detection of prostate cancer in younger men, there is a greater emphasis on the appropriate management of ED following RP. A number of options are available to manage ED after RP, including phosphodiesterase-5 inhibitors, intracorporeal injections, intraurethral alprostadil, and vacuum erection devices (VEDs). Penile rehabilitation programs are increasingly used to facilitate the return of natural postoperative erections; the VED is an ideal therapy given that it increases blood flow and oxygenation to the corpora to reverse the changes that result in ED after RP.

Hoyland, Kimberley; Vasdev, Nikhil; Adshead, James

2013-01-01

187

Albert Einstein researchers identify risk markers for erectile dysfunction following radiation treatment in prostate cancer  

Cancer.gov

In the first study of its kind, a research team led by Albert Einstein College of Medicine of Yeshiva University and Mount Sinai School of Medicine discovered 12 genetic markers associated with the development of erectile dysfunction (ED) in prostate cancer patients who were treated with radiation. The findings, published online in the International Journal of Radiation Oncology • Biology • Physics, are an important step toward helping clinicians determine the best course of treatment for prostate cancer patients and may lead to the development of therapies that alleviate side effects.

188

The effect of topically applied vasoactive agents and testosterone versus testosterone in the treatment of erectile dysfunction in aged men with low sexual interest  

Microsoft Academic Search

The objective was to evaluate the efficacy and safety of topically applied cream containing testosterone, isosorbide dinitrate and co-dergocrine mesylate compared to testosterone cream in the treatment of erectile dysfunction in aged men with low sexual interest. A randomised double-blind crossover trial was performed over two months. The subjects were 42 men with erectile dysfunction and low normal or slightly

A Gomaa; M Eissa; A El-Gebaley

2001-01-01

189

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

PubMed

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

2013-05-06

190

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.

El-Sakka, Ahmed I

2013-01-01

191

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

PubMed

Sildenafil citrate, an oral therapy for erectile dysfunction, is a selective inhibitor of cyclic guanosine monophosphate (cGMP)-specific phosphodiesterase type 5 (PDE5), the predominant isozyme metabolizing cGMP in the corpus cavernosum. Chemically, it is a compound of the pyrazolo-pyrimidinyl-methylpiperazine class. Sildenafil has no direct relaxant effect on human corpus cavernosum but enhances the relaxant effect of nitric oxide (NO) on the corpus cavernosum by inhibiting PDE5, which is responsible for degradation of cGMP in this tissue. When sexual stimulation causes local release of NO, inhibition of PDE5 by sildenafil increases concentrations of cGMP in the corpus cavernosum, causing smooth muscle relaxation and blood flow into the penis, resulting in an erection. Sildenafil at recommended doses has no effect in the absence of sexual stimulation. The drug is rapidly absorbed after oral administration, with absolute bioavailability of 40%. Its pharmacokinetics are dose proportional over the recommended dosage range. Maximum plasma concentrations are reached within 30 to 120 minutes after oral dosing in the fasting state. Sildenafil is cleared predominantly by the hepatic microsomal isoenzymes CYP3A4 (major route) and CYP2C9 (minor route). Clinical studies assessed the effect of sildenafil on the ability of men with erectile dysfunction to engage in sexual activity and, specifically, to achieve and maintain an erection sufficient for satisfactory sexual intercourse. Sildenafil was evaluated at doses of 25, 50, and 100 mg in randomized, double-masked, placebo-controlled clinical trials of up to 6 months' duration. The drug was administered to hundreds of patients aged 19 to 87 years having erectile dysfunction of various etiologies for a mean duration of 5 years. Sildenafil was associated with statistically significant improvement in erectile function compared with placebo. Adverse effects reported at a rate of >2% were headache, flushing, dyspepsia, nasal congestion, urinary tract infection, abnormal vision, diarrhea, dizziness, and rash. No cases of priapism were reported. The use of sildenafil is contraindicated in men who are taking organic nitrates, because of the potential for a precipitous decrease in blood pressure. Postmarketing reports and surveillance have revealed at least 39 deaths with sildenafil use in men having a history of heart disease, men taking nitrate medications, and men in poor physical health due to lack of exercise. Many of the men who experienced serious adverse effects or death had a variety of concomitant diseases and were taking multiple medications. PMID:9916601

Goldenberg, M M

192

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.

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

193

Does therapeutic dose of sildenafil citrate treatment lead to central serous chorioretinopathy in patients with erectile dysfunction?  

PubMed

The possible effects of sildenafil citrate administration at therapeutic dosage on visual acuity, color vision, intraocular pressure, macular thickness, macular volume, and central serous chorioretinopathy in patients with erectile dysfunction were evaluated. The study consisted of 43 male patients diagnosed as having erectile dysfunction according to the first five question version of International Index of Erectile Function (IIEF-5). All patients were given sildenafil citrate 50 mg po 2 to 3 times/week for a month. The patients were evaluated at the first week and at the end of the treatment. The macular thickness and volume assessments with optic coherence tomography did not differ significantly in foveal, parafoveal areas, parafoveal superior hemisphere, parafoveal inferior hemisphere, parafoveal temporal, superior, nasal, and inferior quadrants. Central serous chorioretinopathy was not found in any of the patients. PMID:23479433

Damar, Elif; Toklu, Yasin; Tuncel, Altug; Balci, Melih; Aslan, Yilmaz; Simsek, Saban; Atan, Ali

2013-03-10

194

Erectile Dysfunction  

MedlinePLUS

... several new treatments for ED. For many men, the answer is as simple as taking a pill. Getting more exercise, losing weight or stopping smoking may also help. NIH: National Institute of Diabetes and Digestive and Kidney Diseases

195

Erectile Dysfunction  

MedlinePLUS

... avoid alcohol, and don't use street drugs. Exercise regularly. Take steps to reduce stress. Get help for anxiety or depression. Symptoms Mayo Clinic products and services Book: Mayo Clinic on Healthy Aging Give ...

196

Post-marketing surveillance study of the safety and efficacy of sildenafil prescribed in primary care to erectile dysfunction patients  

Microsoft Academic Search

In order to investigate the safety and efficacy of sildenafil prescribed in primary care, a post-marketing surveillance study was undertaken. A total of 651 men with erectile dysfunction (ED) were enrolled from 31 family physicians in Korea from December 1999 to July 2002. Patients were regularly followed up to ascertain the safety and efficacy of sildenafil. Of the 651 patients

S Sunwoo; Y S Kim; B L Cho; K S Cheon; H G Seo; M K Rho; Y S Cheong; M H Hong; S W Kim; D H Kim

2005-01-01

197

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

Microsoft Academic Search

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

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

2003-01-01

198

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

Microsoft Academic Search

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

RB Moreland

2000-01-01

199

Association between Erectile Dysfunction and Coronary Artery Disease: Matching the Right Target with the Right Test in the Right Patient  

Microsoft Academic Search

IntroductionEvidence is accumulating in favour of a link between erectile dysfunction (ED) and coronary artery disease (CAD). This review attempts to identify which patients, among those with ED and no cardiovascular (CV) disease, should be screened for early, subclinical CAD, which coronary targets should be investigated, and which tests should be used.

Piero Montorsi; Paolo M. Ravagnani; Stefano Galli; Andrea Salonia; Alberto Briganti; José P. Werba; Francesco Montorsi

2006-01-01

200

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

ERIC Educational Resources Information Center

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

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

2011-01-01

201

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

ERIC Educational Resources Information Center

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

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

2011-01-01

202

Where Cost, Medical Necessity, and Morality Meet: Should US Government Insurance Programs Pay for Erectile Dysfunction Drugs?  

Microsoft Academic Search

Spending for the three most popular phosphodiesterase (PDE) inhibitor drugs to treat erectile dysfunction (ED) tops $1 billion worldwide annually. Using Medicaid and Medicare Part D as examples, we explore here whether US government insurance programs with limited budgets should reimburse for this class of ED drugs and review the common bases for justifying and denying reimbursement. We conclude that

J M Polinski; A S Kesselheim

2011-01-01

203

Impact of introduction of sildenafil on other treatment modalities for erectile dysfunction: a study of nationwide and local hospital sales  

Microsoft Academic Search

We assess the impact of introduction of sildenafil on alprostadil injection and penile implant surgery for the treatment of erectile dysfunction (ED) at our institution and in Taiwan. The data of national sales of sildenafil, alprostadil injection and penile implant were provided by industry companies. In the meanwhile, we analyzed the users of the above-mentioned three treatments at our institution.

B-P Jiann; C-C Yu; C-C Su

2004-01-01

204

Clomiphene increases free testosterone levels in men with both secondary hypogonadism and erectile dysfunction: who does and does not benefit?  

Microsoft Academic Search

Secondary hypogonadism is more common than primary gonadal failure and is seen in chronic and acute illnesses. Although testosterone has a role in erections, its importance in erectile dysfunction (ED) has been controversial. Hypogonadism produced by functional suppression of pituitary gonadotropins has been shown to correct with clomiphene citrate, but with a modest effect on sexual function. We wondered if

A T Guay; J Jacobson; J B Perez; M B Hodge; E Velasquez

2003-01-01

205

Application of angiogenic factors for therapy of erectile dysfunction: Protein and DNA transfer of VEGF 165 into the rat penis  

Microsoft Academic Search

ObjectivesTo establish a laboratory animal model for vascular endothelial growth factor (VEGF) transfer in the rat penis to invent a curative therapy for erectile dysfunction (ED). Vascular insufficiency is a common pathomechanism of ED. Previous investigations have shown neovascularization of ischemic organs after gene transfer of VEGF.

Martin Burchardt; Tatjana Burchardt; Aristotelis G. Anastasiadis; Ralph Buttyan; Alexandre de la Taille; Ahmad Shabsigh; Jorge Frank; Ridwan Shabsigh

2005-01-01

206

Pharmacological Prevention and Reversion of Erectile Dysfunction After Radical Prostatectomy, by Modulation of Nitric Oxide/cGMP Pathways.  

National Technical Information Service (NTIS)

This project aims to find a novel therapy to prevent or correct erectile dysfunction (ED) after radical prostatectomy (RP) for prostate cancer. This was done by determining in a rat model of bilateral cavernosal nerve resection (BCNR): a) the time course ...

N. F. Gonzalez-Cadavid

2011-01-01

207

Quality of life effects of alprostadil therapy for erectile dysfunction: results of a trial in Europe and South Africa  

Microsoft Academic Search

Objectives: Quality of life (QOL) data were used to evaluate the effects of self-administered intracavernosal injection of alprostadil for erectile dysfunction, when used for up to 18 months during a 13 country Phase III clinical trial.Methods: The Duke Health Profile was used to measure patients’ physical and psychosocial QOL at baseline, 3, 6, 12 and 18 months. Changes from baseline

RJ Willke; W Yen; GR Parkerson; OI Linet; MH Erder; HA Glick

1998-01-01

208

Regenerative Medicine in Andrology: Tissue Engineering and Gene Therapy as Potential Treatment Options for Penile Deformations and Erectile Dysfunction  

Microsoft Academic Search

Tissue engineering and gene therapy are currently investigated in animal studies for reconstructing penile tissue or treating erectile dysfunction. This review aims to examine these experimental efforts from the last years and tries to give a brief introduction to the basic methodology of these new techniques from the field of regenerative medicine.

Dirk Schultheiss

2004-01-01

209

Erectile dysfunction association with physical activity level and physical fitness in men aged 40–75 years  

Microsoft Academic Search

The aim of this study is to evaluate the association between physical activity level and physical fitness with erectile dysfunction in men aged 40–75 years. We examined 180 men aged 40–75 years. The individuals were evaluated for age, presence of dyslipidemia and smoking and for anthropometric parameters for the characterization of body mass index. For assessing the level of physical

L C M Agostini; J M B Netto; M V Miranda; A A Figueiredo

2011-01-01

210

Relation between Psychosocial Risk Factors and Incident Erectile Dysfunction: Prospective Results from the Massachusetts Male Aging Study  

Microsoft Academic Search

Erectile dysfunction (ED) is recognized as a major public health problem. ED may be due to a wide range of factors, but recent work has focused on the medical and physical etiology of ED. The importance of psychosocial risk factors should not be dismissed, however, and several cross-sectional studies have reported associations between ED and depression, anger, and dominance. Whether

Andre B. Araujo; Catherine B. Johannes; Henry A. Feldman; Carol A. Derby; John B. McKinlay

211

[A new pathogenetic approach and a method of erectile dysfunction treatment and prevention--modulated erectile oxygenation of penile cavernous tissue].  

PubMed

The analysis of sexual activity of 185 male Muscovites has revealed an age-related sharp progressive shortening of adequate and spontaneous erections. A novel, pathogenetically sound approach and a method of therapy and prevention of erectile dysfunction has been developed (RF patent N 2228754). The method, called "Modulated Erectile Oxygenation of Penile Cavernous Tissue" (MEOPCT), consists in erection activation by behavioral measures and/or erectogenic drugs which induce adequate, nocturnal spontaneous and/or artificial erections adequate in frequency and duration for providing such oxygenation of cavernous bodies that warrants maintenance of their normal structure and function. There is no continuous close correlation between sexual activity and erections, on the one side, and ejaculation and orgasm, on the other side. Application of MEOPCT in 43 patients demonstrated the method ability to improve erection and cavernous hemodynamics without negative side effects. PMID:15560163

Segal, A S; Pushkar', D Iu

212

NADPH oxidase activation: a mechanism of erectile dysfunction in a rat model of sleep apnea.  

PubMed

Erectile dysfunction (ED) is a frequent occurrence in male patients with obstructive sleep apnea syndrome (OSAS). Long-term intermittent hypoxia (LTIH), one of the hallmarks of OSAS, could mediate ED. The objective of this study was to test the hypothesis that increased nicotinamide adenine dinucleotide phosphate (NADPH) oxidase activity contributes to ED in rat responses to LTIH. Healthy male Sprague-Dawley rats were randomly distributed into 4 groups: a LTIH group, an apocynin (a selective NADPH oxidase inhibitor)-treated LTIH group, a sham LTIH group, and an apocynin-treated sham group. Erectile function was examined by measuring the mean arterial blood pressure (MAP) and intracavernosal pressure (ICP) on electrical stimulation of the cavernous nerve. Real-time quantitative polymerase chain reaction and Western blot were used to examine mRNA and protein expression of NADPH oxidase subunit in corpus cavernosa (CC). The level of malondialdehyde and superoxide dismutase were detected by colorimetry. Nitric oxide synthase (NOS) isoforms in CC were also investigated. LTIH markedly attenuated the erectile responses (ICP/MAP), and these were partially prevented by apocynin treatment. Promoted oxidative stress-associated NADPH oxidase subunit activation was found in CC from LTIH rats. Decreased expression and activity of constitutive NOS (cNOS), including endothelial NOS and neuronal NOS, associated with enhanced inducible NOS (iNOS) expression and activity were observed in LTIH rats. Apocynin prevented the decrease in cNOS activity and inhibited iNOS expression and activity in LTIH rats. These results indicate that NADPH oxidase activation plays an important role in the pathogenesis of LTIH-mediated ED. PMID:22653964

Liu, Kui; Liu, Xian-Sheng; Xiao, Li; Shang, Jin; Li, Ming-Chao; Xu, Yong-Jian; Liu, Hui-Guo

2012-05-31

213

Glyco-metabolic profile among type 2 diabetic patients with erectile dysfunction.  

PubMed

The aim of this study was to evaluate the glyco-metabolic profile among type 2 diabetic patients with erectile dysfunction (ED). We evaluated 88 type 2 diabetic males, aged 62.78 ± 9.26 years. We administered patients the IIEF (International Index of Erectile Function) questionnaire to assess erectile function, organ function, sexual desire, and satisfaction level during and after the sexual intercourse and the SAS (self-rating anxiety scale) and SDS (self-rating depression scale) questionnaires to evaluate anxiety and depression. We evaluated: BMI, abdominal circumference, glycated hemoglobin (HbA(1c)), fasting plasma glucose (FPG), fasting plasma insulin (FPI), HOMA index, lipid profile, testosterone, free testosterone, dihydrotestosterone, and sex hormone binding globulin (SHBG). The IIEF questionnaire showed that in the examined sample there were 50 patients (56.8%) affected by ED, and 38 patients (43.2%) without ED. Comparing the two groups, 57.9% of patients without ED, and 70.0% of patients with ED were smokers, and the difference between the two groups was significant (p<0.05). Furthermore, 23.7% of patients without ED, and 38.0% of patients with ED had a history of chronic ischemic heart disease (p<0.05 between the two groups). Patients with ED were older, and, surprisingly, had lower levels of HbA(1c). Furthermore, patients with ED had higher levels of FPI, and lower levels of testosterone and dihydrotestosterone. The prevalence of ED in Italian type 2 diabetic males with mean age of 62 years is about 56% and it is linked to higher levels of FPI, but lower levels of HbA(1c), free testosterone and dihydrotestosterone. PMID:22572549

Derosa, Giuseppe; Tinelli, Carmine; D'Angelo, Angela; Ferrara, Gianluca; Bonaventura, Aldo; Bianchi, Lucio; Romano, Davide; Fogari, Elena; Maffioli, Pamela

2012-05-26

214

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 dysfunc¬tion (ED). Myeloperoxidase (MPO), a heme-containing enzyme mainly released by activated neutro¬phils 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 bio¬markers 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

215

Treatment of erectile dysfunction in patients with cardiovascular disease : guide to drug selection.  

PubMed

Erectile dysfunction (ED) is common in cardiac patients and shares the same risk factors--smoking, hypertension, hyperlipidaemia and diabetes mellitus. Sexual activity is not unduly stressful to the heart and, providing patients are properly assessed using established guidelines, sexual intercourse can be enjoyed without increased risk. The treatment of ED in patients with cardiovascular disease has been transformed by the introduction of the oral phosphodiesterase type 5 inhibitors, the first of which was sildenafil. Success in restoring erectile function is possible in up to 80% of patients (depending on the aetiology) with minimal adverse effects. A synergistic hypotensive effect with nitrates, and almost certainly nicorandil, is the only major contraindication. ED in asymptomatic patients may be a marker of silent vascular disease or increased vascular risk factors and should alert the physician to the need for cardiac risk screening. ED is common in patients with cardiovascular disease and should be routinely enquired about. ED is a distressing condition for the man and his partner, and severely impairs quality of life. Patients with cardiovascular disease and patients with diabetes represent the largest group of patients with ED, the majority of whom benefit from the drug therapies currently available. Addressing ED in patients with cardiovascular disease can lead to a substantial improvement in quality of life and success is not difficult to achieve. PMID:15233591

Jackson, Graham

2004-01-01

216

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

PubMed Central

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

Arrabal-Polo, Miguel Angel; Arias-Santiago, Salvador; Lopez-Carmona Pintado, Fernando; Merino-Salas, Sergio; Lahoz-Garcia, Clara; Zuluaga-Gomez, Armando; Arrabal-Martin, Miguel

2012-01-01

217

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.

Green, Roger; Hicks, Rodney W

2011-01-01

218

Prospective study of restless legs syndrome and risk of erectile dysfunction.  

PubMed

In our previous cross-sectional study, we found that restless legs syndrome (RLS) was associated with erectile dysfunction (ED). Thus, we conducted a prospective study to examine whether RLS was associated with a higher risk of developing ED based on 6 years of follow-up among 10,394 men (mean age = 63.4 years) in the Health Professionals Follow-up Study. RLS was assessed in 2002 using a set of standardized questions recommended by the International RLS Study Group. Erectile function was assessed by means of questionnaires in 2000, 2004, and 2008. We identified 1,633 incident ED cases. Men with RLS were more likely to develop ED (relative risk = 1.38, 95% confidence interval: 1.14, 1.68; P = 0.001) than were those without the syndrome, after adjustment for potential confounders, such as age, body mass index, smoking, physical activity, other sleep disorders, and snoring status. A higher frequency of RLS symptoms was also associated with an increased risk of ED (P(trend) = 0.001). In conclusion, men with RLS had a higher risk of ED, and the magnitude of the risk increased with a higher frequency of RLS symptoms. Combinations of other sleep disorders with RLS further increased the risk of ED. PMID:23608708

Li, Yanping; Batool-Anwar, Salma; Kim, Sehee; Rimm, Eric B; Ascherio, Alberto; Gao, Xiang

2013-04-21

219

Impact of frequency of intercourse on erectile dysfunction: a cross-sectional study in Wuhan, China.  

PubMed

This study was aimed to investigate the influence of coital frequency and masturbation on erectile dysfunction (ED) in Chinese patients. A total of 332 male outpatients with or without ED and volunteers were recruited from Zhongnan Hospital, Wuhan University, China. ED was assessed by using the five-item International Index of Erectile Function scale and the frequency of intercourse by patients' self-report. After adjusting for lifestyle factors and diseases-related factors, the analyses showed that coital and masturbation in a certain frequency tended to decrease the risk of ED. Men reporting intercourse once a week had lower risk of ED than those did less than once a week, with age, hyperlipidemia, hypertension, diabetes, body mass index, smoking, and drinking as covariates (P=0.67, adjusted odds ratio [OR] = 0.84; 95% confidence interval [CI]: 0.37-1.88). For those reporting coital frequency two times per week and three or more times per week, there were 63% (adjusted OR = 0.37; 95% CI: 0.18-0.77) and 85% (adjusted OR = 0.15; 95% CI: 0.07-0.35) lower risk of ED than those reporting intercourse frequency less than once per week, respectively (P<0.05). Results indicated that maintaining a regular frequency of intercourse can reduce the risk of ED for males aged among 30 to 75 years. PMID:22684564

Qin, Zhanting; Tian, Binqun; Wang, Xinghuan; Liu, Tongzu; Bai, Jinbing

2012-06-09

220

Chinese herb formulae for treatment of erectile dysfunction: a systematic review of randomised controlled clinical trials.  

PubMed

To assess the beneficial and adverse effects of orally therapies of Chinese herb formulae (CHF) for erectile dysfunction (ED), four electronic databases were searched until 23 June 2012. Randomised clinical trials testing CHF or combined with Western medicine therapy (WMT) against placebo, another different CHF and WMT were included. Study selection, data extraction, assessing of bias risk and data analysis were conducted according to the Cochrane handbook. Twenty-one randomised controlled clinical trials (involving 2253 patients) were included, and the bias risks were not low. Funnel plots of comparing CHF to another CHF on the clinical comprehensive effectiveness were asymmetrical. The compositions of CHF used were greatly complex. The analyses showed that some CHF or combined with WMT had significant effects on cure rate, total clinical effective rates, IIEF-5 scores, erectile quality scores, erection angles of penis and recovery times of erection compared with the controls. Eight trials reported mild adverse drug reactions, mostly involving gastrointestinal symptoms. It was concluded that some therapies of CHF may be more effective than the controls for treatment of ED. However, because of the generally not low risks of bias, CHF are not recommended for ED. Further research that demonstrates their mechanisms of action and meaningful efficacies must be carried out by rigorously designed, randomised controlled trials. PMID:23421655

Xiong, G; Li, B; Wang, K; Li, H

2013-02-20

221

The Assessment of Sexual Functions in Women with Male Partners Complaining of Erectile Dysfunction: Does Treatment of Male Sexual Dysfunction Improve Female Partner's Sexual Functions?  

Microsoft Academic Search

The aims of this prospective study were to compare sexual functioning between women with male partners who have erectile dysfunction (ED) and women without partners with ED and also to investigate the effect of the treatment of male ED on female partner's sexual function. The study included 87 women and their male partners. We divided the women into two groups:

SELAH?TT?N ÇAYAN; MURAT BOZLU; BÜLENT CANPOLAT; ERDEM AKBAY

2004-01-01

222

Lower Urinary Tract Symptoms, Benign Prostatic Hyperplasia, Erectile Dysfunction, and Phosphodiesterase-5 Inhibitors  

PubMed Central

Many patients who present to their healthcare provider with lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) will also have erectile dysfunction (ED), and vice versa. Although ?-adrenergic receptor blockers and 5-?-reductase inhibitors are highly effective in treating BPH-associated LUTS, these agents have sexual adverse effects that cause many men to discontinue therapy. The discovery of nitric oxide as a major factor in the mechanism of erection has led to the development of new drugs for ED, including the phosphodiesterase (PDE) inhibitors. Preliminary data support the theory that inhibition of PDE isoenzymes in the prostate may improve LUTS due to BPH through relaxation of prostatic smooth muscle. Further studies of PDE inhibitors in men with ED and BPH-associated LUTS are indicated.

Roehrborn, Claus G

2004-01-01

223

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.

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

2013-01-01

224

Oral Pharmacotherapy and the Contemporary Evaluation and Management of Erectile Dysfunction  

PubMed Central

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

Broderick, Gregory A

2003-01-01

225

Bilateral simultaneous nonarteritic anterior ischemic optic neuropathy after ingestion of sildenafil for erectile dysfunction.  

PubMed

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

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

2012-03-19

226

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

227

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

PubMed

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; Kim, Soo Woong

2013-08-31

228

[Chinese herbal drugs for erectile dysfunction through NO-cGMP-PDE5 signaling pathway].  

PubMed

Great progress has been made in the basic researches on erectile dysfunction (ED) ever since the recognition of the close association of micromolecular nitric oxide (NO) with penile smooth muscle relaxation in 1990. NO-cGMP-PDE5 signaling pathway plays an important role in regulating the relaxation of corpus cavernosum smooth muscle, and its relevant studies have contributed greatly to the clinical treatment of ED. Chinese herbal drugs have long been used in the treatment of ED, and the action mechanisms of some of them clarified through the NO-cGMP-PDE5 signaling pathway. This article presents an overview on the recent advances in the studies of ED treatment with Chinese herbal drugs. PMID:22474995

Liao, Hui; Jacob, Rajfer

2012-03-01

229

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.

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

2011-01-01

230

Chronic Low Dosing of Phosphodiesterase Type 5 Inhibitor for Erectile Dysfunction  

PubMed Central

Oral phosphodiesterase type 5 (PDE5) inhibitors have provided non-invasive, effective, and well-tolerated treatments for patients with erectile dysfunction (ED). However, many patients with ED are unresponsive to 'on-demand' PDE5 inhibitors. In addition, the lack of spontaneity and naturalness of the on-demand regimen could be a reason for decreased compliance with PDE5 inhibitors. Recently, tadalafil and udenafil were approved for low-dose daily administration for the treatment of ED. Since the introduction of the concept of daily administration of PDE5 inhibitors, several reports have supported the potential benefits of this therapy for disease modification, improvement of the treatment response in difficult-to-treat populations, spontaneity, and safety, although further research is needed to better address these hypotheses. In this article, we reviewed the daily administration of PDE5 inhibitors in terms of pharmacokinetics, safety, efficacy, and distinct features.

Sung, Hyun Hwan

2012-01-01

231

The effects of stress and coping upon the diagnostic intracavernous injection in men with erectile dysfunction.  

PubMed

The diagnostic intracavernous injection (ICI) can be considered to be a stressful situation because it may exacerbate worries about the 'sexual' function and because it is an invasive procedure. The individual's primary appraisal (harm or pain caused by the injection, performance anxiety, fear of success as well as fear of failure) and his secondary appraisal (general coping style as well as the (in)effectiveness of this function) could influence the ICI. Therefore, coping style and anxiety levels were assessed in men with erectile dysfunction. These psychometric characteristics were correlated with the subsequent ICI with prostaglandin E1 (PGE1): the individual's anxiety level does not, but the coping style does explain a significant part of the variation in ICI response. Indeed, avoidance and palliative coping have a negative impact on the penile response following ICI. The present study suggests that coping style should be included in further psychophysiological studies of the ICI response. PMID:8636918

van der Borght, W; Vanderschueren, D; Demyttenaere, K

1995-10-01

232

Prevalence of Erectile Dysfunction in HTLV-1 Infected Patients and its Association with Overactive Bladder  

PubMed Central

Objective To determine the prevalence of erectile dysfunction (ED) in HTLV-I infected patients, and its association with overactive bladder (OB). Methods In a cross-sectional study 111, male patients with positive serology for HTLV-I (by ELISA and Western blot) were examined between October, 2003 and December, 2006. Exclusion criteria were age <18 and >80 years, other neurological diseases, penile prosthesis, neoplasm, and psychological and mental disease. Patients were evaluated by a urologist and neurologist. ED was determined by application of the abridged form of International Index of Erectile Dysfunction (IIEF-5). ED was defined as IIEF-5 ? 21. OB was determined by International Continence Society (ICS) criteria. Using the Expanded Disability Status Scale (EDSS) to determine disautonomy status, a neurologist classified all patients as either asymptomatic carriers (EDSS=0), “oligosymptomatic myelopathy” (EDSS>0 e ?2), or HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP); (EDSS>2). Diagnosis of HAM/TSP was performed according to WHO recommendations. Results After six patients were excluded, 105 were analyzed. The mean age was 48±10.7 years. ED was observed in 55.2%. ED was documented in all patients who had HAM/TSP, in 79% of the group with EDSS>0 and ?2, and in 35.9% of HTLV-1 infected individuals with EDSS = 0. OB was detected in 93.75%, 33.3% and 4.6% respectively. Moreover there was an association observed between ED and OB. Conclusion ED is a frequent disease in HTLV-I-infected individuals, and the prevalence is directly correlated to the neurological disability degree measured by EDSS. ED was strongly associated with OB symptoms.

Oliveira, Paulo; Castro, Neviton M; Muniz, Andre L; Tanajura, Davi; Brandao, Julio C; Porto, Aurelia F; Carvalho, Edgar M

2009-01-01

233

Management of premature ejaculation -- a comparison of treatment outcome in patients with and without erectile dysfunction.  

PubMed

This study evaluated the problem of premature ejaculation (PE) in patients treated for erectile dysfunction. The aim was to compare the efficacy of selective serotonin reuptake inhibitors (SSRIs) in the management of primary PE and PE associated with sildenefil treatment. Eighty-seven patients with PE seen over a period of 17 months were recruited into this prospective study. They were categorized into two groups: primary PE (GPI) and PE in sildenefil-treated patients (GPII). All patients recruited into GPII had erectile dysfunction (ED) that was successfully treated with sildenefil citrate for at least a year. Both groups of patients were given sertraline 50 mg 4 h before expected time of sex. The minimum follow-up was 6 months. The ejaculation latency before and after treatment of the two groups were compared. The sexual satisfaction scores of the patients in the two groups were also sought and analysed. Twenty-eight percent of patients with ED who were successfully treated with sildenefil developed PE. Subjects in group GPI were younger and have less comorbid factors than those in group GPII. There was no significant difference in the mean ejaculation latency for both groups (46 vs. 34.6 sec for GPI and GPII, respectively). However, there was highly significant difference in the ejaculation latency between the two groups after treatment with sertraline for 6 months (247.2 vs. 111.6 sec for GPI and GPII, respectively). There was also significant difference in the sexual satisfaction score for group GPI post-treatment, but not for GPII. No significant side-effect of sertraline was reported from patients in both groups. Successful treatment of ED could not assure sexual satisfaction. At least a quarter of sildenefil treated ED patients might develop PE which would continue to frustrate these patients sexually. While selective serotonin re-uptake inhibitors (SSRIs) was effective in the management of primary PE, they were not as effective in patients with sildenefil corrected ED. PMID:12270028

Chia, Sing joo

2002-10-01

234

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

PubMed

The study was aimed to evaluation of the effectiveness of vibromagnitic lazer therapy (VMLT) of erectile dysfunction (ED) in patients with chronic prostatitis (CP). The study included 40 patients with CP, aged 22 to 45 years. CP duration ranged from 6 months to 9 years, ED--from 6 months to 7 years. All the patients underwent a survey on "Chart of sexological examination of man" with the calculation of sex constitution index, an transrectal ultrasonography of prostate gland (PG), uroflowmetry, clinical and functional assessment of components of the copulatory interval, and assessment of blood plasma concentrations of peptide and steroid hormones. All patients underwent a psychotherapeutic correction of sexual disadaptation, sex therapy using Masters-Johnson, Kaplan, and Lo Piccolo methods, and VMLT using "Matrix-Urologist" device. The control group included 20 healthy men aged 22 to 45 years. All studies were performed Before and 30 days after the end of the last VMLT session. As a result of the treatment, integral IIEF indicators were normalized in 60% of patients, the volume of the prostate--in 70%, hemodynamics in the phase of relaxation and erection--in 70%, venous blood flow in the PG--in 70%, dorsal artery hemodynamics in the phase of relaxation and erection--in 60%, and penile hemodynamics--in 60% of patients. Voiding bladder function was optimized in 75% of patients. The functional activity of the pituitary-adrenal-testicular system returned to normal level in 60% of patients. 1 year after treatment, sexual function was maintained at attained levels in 47.5% of patients. As a matter of findings, it was concluded that VMLT is high effective method of combined non-pharmacological correction of erectile dysfunction in CP patients with strong and medium sex constitution. PMID:23342618

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

235

Pilot study of the endothelin-A receptor selective antagonist BMS-193884 for the treatment of erectile dysfunction.  

PubMed

Endothelins have been postulated to be important regulators of penile erectile function. The endothelin-A receptor antagonist BMS-193884 was evaluated as a treatment for mild-to-moderate erectile dysfunction in an animal model and in human volunteer subjects. In laboratory studies, organ bath preparations of rabbit and human penile cavernosal tissue strips were incubated with BMS-193884 and exposed to increasing concentrations of endothelins. In rabbit tissue, 1 microM BMS-193884 significantly inhibited contraction to ET-1, ET-2, and ET-3 by 34.5%, 42.9%, and 100%, respectively. In human tissue, 1 microM BMS-193884 inhibited contraction to ET-2 by 44.4%. In rabbit tissue strips contracted with 20 nM of ET-1 or ET-2, BMS-1 93884 caused dose-dependent relaxation with EC50 values of 107.2 +/- 32.3 nM and 1.7 +/- 0.5 nM, respectively. In anesthetized male rabbits, intravenous administration of BMS-193884 (systemic plasma concentration approximately 50 and 100 nM) increased the duration of pelvic nerve-stimulated penile erection. To further assess the safety and efficacy of BMS-193884, 53 men diagnosed with mild-to-moderate erectile dysfunction were administered oral placebo or 100 mg BMS-193884 in a double-blind fashion. Evaluations were based on 1) erectile function testing during 2 in-office visits and 2) diary and questionnaire data of 4 intercourse attempts over 2-4 weeks of home use. Although the drug was well tolerated, BMS-193884 did not significantly improve erectile function during office visits or home use when compared to placebo. Thus, BMS-193884 facilitated cavernosal smooth muscle relaxation ex vivo and prolonged penile tumescence in vivo. In contrast, a pilot clinical study failed to show enhancement of erectile response in men with mild-to-moderate erectile dysfunction. The disparity between the laboratory and clinical studies suggests that there may be differences between species with regard to the role of endothelin in erectile function. PMID:11780926

Kim, Noel N; Dhir, Vinita; Azadzoi, Kazem M; Traish, Abdulmaged M; Flaherty, Elizabeth; Goldstein, Irwin

236

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

PubMed

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

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

2009-02-23

237

[Effectiveness of and tolerance to intracavernous injection of moxisylyte in patients with erectile dysfunction: effect/dose relationship versus placebo].  

PubMed

The authors investigated the optima dose (efficacy and safety) of moxisylyte, an alpha-blocking agent, in a double-blind placebo-controlled crossover study in 30 patients. The origin of the erectile dysfunction was predominantly psychological in 14 patients and neurological in 16 patients. Each patient received 4 intracavernous injections in a randomized order (placebo, 10, 20, 30 mg of moxisylyte) at 7-day intervals. Regardless of the dose, moxisylyte induced significantly greater penile responses than placebo on all erection criteria. The frequency of responses allowing sexual intercourse appeared to be dose-dependent in the two aetiological groups. The erectile responses most frequently obtained were complete rigidity in the "neurological" group and tumescence in the "psychological" group. The safety was excellent for 95.6% of injections and no case of priapism was observed. One patient (neurological patient) experienced two prolonged erections after the dose of 20 mg and another patient (psychological patient) reported 2 headaches after the dose of 30 mg. No pain was experienced on injection. Moxisylyte is very well tolerated and is able to induce an erectile response from the dose of 10 mg. This dose appears to be sufficient in patients with central neurological erectile dysfunction; a dose of 20 mg tends to improve the quality of response in patients with a predominantly psychological disorder, although the differences observed between the doses were not statistically significant in this number limited of patients. PMID:8580980

Navratil, H; Costa, P; Louis, J F; Andro, M C; Saur, P

1995-11-01

238

Erectile dysfunction drugs and risk of anterior ischaemic optic neuropathy: casual or causal association?  

PubMed Central

Phosphodiesterase type 5 (PDE5) inhibitor drugs for erectile dysfunction have revolutionised the treatment of male sexual dysfunction and are among the best selling drugs worldwide. Several cases of non?arteritic anterior ischaemic optic neuropathy (NAION) have been reported since 2005 in users of these agents. NAION is a sudden irreversible cause of visual loss with a poorly understood aetiology that affects up to 10 adults per 100?000 each year. Following a series of such case reports, WHO and FDA have labelled the association between use of PDE5 inhibitors and risk of NAION as “possibly” causal. There have been several recent studies of this association, including a rechallenge case report and a large managed care database study. However, the inability to confirm or refute claims of an association between NAION and EDD is generating clinical and regulatory uncertainty. Questions surrounding use of PDE5 inhibitors and risk of NAION highlight weaknesses in current systems used to identify and evaluate uncommon adverse effects of medication use. This paper reviews all the recent evidence on PDE5 inhibitors and the risk of NAION.

Danesh-Meyer, Helen V; Levin, Leonard A

2007-01-01

239

Testosterone Is Associated with Erectile Dysfunction: A Cross-Sectional Study in Chinese Men  

PubMed Central

Background Testosterone is essential for the regulation of erectile physiology, but the relationship between low testosterone and erectile dysfunction (ED) has not been firmly established. Purpose To examine the association between serum total, free and bio-available testosterone and ED in a population-based sample. Methods A consecutive series of 1776 men aged 20–77 participated in the routine physical examination from September 2009 to December 2009 in Guangxi, China. ED was assessed using the five-item International Index of Erectile Function (IIEF-5) questionnaire. Total testosterone (TT), sex hormone binding globulin (SHBG) and other biochemical profiles were measured. Free testosterone (FT) and bio-available testosterone (BT) were calculated based on Vermeulen’s formula. Data were collected with regard to smoking, alcoholic drinking, physical activity and metabolic syndrome. Results The prevalence of ED (IIEF-5<22) was 47.6%. Men with ED were significantly older, and more prone to smoke cigarettes (?20 cigarettes/day) or drink alcohol (?3 drinks/week), and more likely to have elevated blood pressure (P?=?0.036) or hyperglycemia (P<0.001) compared with those without ED. The significant increase in SHBG with age was parallel to its increase with increasing severity of ED (P<0.001). The obscure increase in TT across the ED status was detected without significance (P?=?0.418), but TT was positively associated with ED after adjustment for age [odds ratio (OR) ?=?1.02, 95% CI (confidence internal): 1.00–1.04]. FT and BT were inversely associated with ED (OR?=?0.14, 95%CI: 0.06–0.33; OR?=?0.92 (95%CI: 0.89–0.96, respectively) in the univariate analysis, and this inverse association appeared to be independent of smoking status, alcoholic drinking, physical activity, hyper-triglyceridemia and hyperglycemia. Conclusions FT and BT are inversely related to worsening ED, whereas the positive association between TT and ED is most likely due to the increase in SHBG.

Gao, Yong; Tan, Aihua; Lu, Zheng; Wu, Chunlei; Zhang, Youjie; Yang, Xiaobo; Zhang, Haiying; Qin, Xue; Mo, Zengnan

2012-01-01

240

Vardenafil: a novel type 5 phosphodiesterase inhibitor for the treatment of erectile dysfunction.  

PubMed

Orally administered phosphodiesterase type 5 (PDE5) inhibitors have become the first-line treatment option for erectile dysfunction (ED). Vardenafil is a potent and highly selective PDE5 inhibitor developed as an oral therapy for ED. Two pivotal, randomised, double-blind, multi-centre studies have evaluated the use of vardenafil in men with ED. Vardenafil improved the rate of achieving and maintaining an erection during sexual intercourse. Improvement was also noted in other aspects of sexual function, including confidence, orgasmic function and overall satisfaction. Vardenafil produces clinically and statistically significant improvements in erectile function regardless of age, baseline severity and aetiology and is efficacious for the treatment of ED in diabetic and postradical prostatectomy patients. Vardenafil has a rapid onset of action, in which erections sufficiently rigid for eventual intercourse completion can be achieved as early as 16 min after ingestion. Vardenafil 20 mg has sustained long-term efficacy by providing up to 92% of patients with improved erections during > 2 years of treatment. Vardenafil is well-tolerated, with an adverse event profile typical of this class of PDE5 inhibitors. The most common adverse events were headache, flushing, rhinitis and dyspepsia, which were mild-to-moderate in severity and they generally attenuated with continued use. Vardenafil may be associated with transient reductions in blood pressure and commensurate increases in heart rate, with the overall incidence of cardiovascular-related adverse events similar to that of placebo. Although claims can be made about potential features of benefit for each of the currently marketed PDE5 inhibitors, there are at present, no non-pharmaceutical company sponsored, peer-reviewed, head-to-head trials that have been published. PMID:15102574

Kendirci, Muammer; Bivalacqua, Trinity J; Hellstrom, Wayne J G

2004-04-01

241

Dehydroepiandrosterone in the treatment of erectile dysfunction in patients with different organic etiologies.  

PubMed

In 1994 the Massachusetts Male Aging Study described an inverse correlation of the serum levels of dehydroepiandrosterone sulfate (DHEAS) and the incidence of erectile dysfunction (ED). The positive results of a pilot study in the treatment in patients with no organic etiology prompted a detailed investigation on the efficacy of DHEA therapy for ED in patients with different organic etiologies, in a prospective study. The inclusion criteria included ED, a normal physical condition, normal serum levels of testosterone, prolactin and PSA and a serum DHEAS level < 1.5 micromol/l. The study patients comprised 27 patients (group 1) with hypertension, 24 patients (group 2) with diabetes mellitus, six patients with neurological disorders (group 3) and 28 patients (group 4) with no organic etiology were treated with 50 mg DHEA p.o. for 6 months. We assessed efficacy by using the responses to question 3 (frequency of penetration) and question 4 (maintenance of erections after penetration) of the 15-question International Index of Erectile Function (IIEF). DHEA treatment was associated with statistically significantly higher mean scores compared to baseline values for question 3 and question 4 of the IIEF in groups 1 and 4 after a period of 24 weeks. The differences between the mean scores of groups 2 and 3 and the baseline values were not statistically significant. Our results suggest that oral DHEA-treatment may be of benefit to patients with ED who have hypertension or to patients with ED without organic etiology. There was no impact of DHEA therapy on patients with diabetes mellitus or with neurological disorders. PMID:11585284

Reiter, W J; Schatzl, G; Märk, I; Zeiner, A; Pycha, A; Marberger, M

2001-08-01

242

A double blind, randomised study of sildenafil citrate for erectile dysfunction in men with multiple sclerosis  

PubMed Central

Objective: Identifying and effectively treating erectile dysfunction (ED) can result in an improvement of the quality of life (QoL) in men with multiple sclerosis (MS). Methods: This randomised, double blind (DB), placebo controlled, flexible dose study with an open label extension (OLE) assessed efficacy, QoL, and safety of sildenafil citrate in men with MS and ED. Overall, 217 men received sildenafil (25–100 mg; n = 104) or placebo (n = 113) for 12 weeks. Efficacy was assessed by the International Index of Erectile Function (IIEF) questionnaire that includes questions on achieving (Q3) and maintaining (Q4) an erection as well as a global efficacy question (GEQ). QoL was also assessed. Results: After 12 weeks, patients receiving sildenafil had higher mean scores for IIEF Q3 and Q4 compared with those receiving placebo (p<0.0001), and 89% (92/103) reported improved erections compared with 24% (27/112) of patients receiving placebo (p<0.0001). At the end of the OLE phase, 95% of men reported improved erections. Patients receiving placebo during the DB phase showed a nearly fourfold increase in improved erections (97% v 26%). Men receiving sildenafil also showed improvements in five of the eight general QoL questions compared with men receiving placebo (p<0.05). The total mean score for the QoL questionnaire improved by 43% for the sildenafil group versus 13% for the placebo group (p<0.0001). Treatment related AEs were predominantly mild in nature, and no patient discontinued due to an AE. Conclusion: Sildenafil treatment for ED in men with MS was effective and well tolerated, and resulted in significant improvements in both general and disease specific QoL variables.

Fowler, C; Miller, J; Sharief, M; Hussain, I; Stecher, V; Sweeney, M

2005-01-01

243

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

PubMed Central

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

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

2013-01-01

244

Sildenafil citrate: a 5-year update on the worldwide treatment of 20 million men with erectile dysfunction  

Microsoft Academic Search

\\u000a Erectile dysfunction (ED) is a highly prevalent condition affecting as many as 50% of men 40 years of age or older. ED, defined\\u000a as “the inability to obtain and maintain erections sufficiently to allow sexual intercourse”, has been widely studied for\\u000a many decades. The first breakthrough in effective, minimally invasive, safe treatment was the establishment of the oral agent\\u000a sildenafil

Culley C. Carson

245

Relationship between chronic tadalafil administration and improvement of endothelial function in men with erectile dysfunction: a pilot study  

Microsoft Academic Search

Men with erectile dysfunction (ED) frequently have a disproportionate burden of comorbid vascular disorders including atherosclerotic disease. We investigated whether scheduled tadalafil is better than on-demand (OD) in improving endothelium-dependent vasodilatation of cavernous arteries in men with ED and whether this effect is also exerted on markers of endothelial function. We did an open-label, randomized, crossover study including 20 male

A Aversa; E Greco; R Bruzziches; M Pili; G Rosano; G Spera

2007-01-01

246

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

Microsoft Academic Search

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

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

2009-01-01

247

Double-blind, placebo-controlled safety and efficacy trial with yohimbine hydrochloride in the treatment of nonorganic erectile dysfunction  

Microsoft Academic Search

This double-blind, placebo-controlled clinical trial of yohimbine hydrochloride included 86 patients with erectile dysfunction and without clearly detectable organic or psychologic causes. The patient group fulfilled all entry criteria; 85 of these could be considered for the Safety-respectively 83 for the Intention-to-treat (ITT)-analysis. Yohimbine was administered orally in a dosage of 30 mg a day (two 5 mg tablets three

H-J Vogt; P Brandl; G Kockott; JR Schmitz; MH Wiegand; J Schadrack; M Gierend

1997-01-01

248

The use of alprostadil sterile powder in a home self-injection study of Asian men with erectile dysfunction  

Microsoft Academic Search

This study evaluated the individual optimal dose of alprostadil in the office setting that could be used as the basis for effective home self-injection therapy. The study included 150 Asian men with erectile dysfunction (ED). The mean age of study participants was 48.3 years (range, 21 to 74 years), and the mean duration of ED was 3.6 years. The most

Charles C. J. Wu; Zhao-Ying Xue; Konganand Apichat; Shih-Tsung Huang; Zhangju He; Roger J. Garceau

1996-01-01

249

Long-term, Multicenter Study of the Safety and Efficacy of Topical Alprostadil Cream in Male Patients with Erectile Dysfunction  

Microsoft Academic Search

Introduction. Alprostadil is approved for treatment of male erectile dysfunction (ED) by injection or urethral insertion. Topical delivery of alprostadil offers an improved alternative. Aim. To evaluate the long-term safety and efficacy of topical alprostadil cream. Methods. This was a multicenter, open-label, long-term study in 1,161 patients (998 double-blind rollover; 163 naïve) with ED. For the first 4 weeks, patients

Michael Rooney; William Pfister; Mary Mahoney; Melissa Nelson; James Yeager; Christopher Steidle

2009-01-01

250

Dose-response studies of intracavernous injection therapy with alprostadil in Asian and Australian men with erectile dysfunction  

Microsoft Academic Search

This is the first report on dose-response results with alprostadil (Caverject® Sterile Powder), a formulation of prostaglandin E1 (PGE1), for the treatment of erectile dysfunction (ED) in 365 Asian and Australian men, 21 to 75 years of age (mean, 48.9 years) with ED from 2 months' to 35 years' duration (mean, 3.8 years). Seven Asian centers conducted an open-label, dose-escalation

Roger J. Garceau; Irene X. Zhang; Liwei Jen

1996-01-01

251

The First HumanTrial for GeneTransferTherapy for the Treatment of Erectile Dysfunction: Preliminary Results  

Microsoft Academic Search

Objective: To test the safety of a single intracavernous injection of a plasmid vector (hMaxi-K) that expresses the hSlo gene, that encodes the a-subunit of the Maxi-K channel, for the treatment of erectile dysfunction (ED). Methods: Six men, thus far have fulfilled the entry criteria of the protocol and had gene transfer with hMaxi-K. Three received a dose of 500

Arnold Melman; Natan Bar-Chama; Andrew McCullough; Kelvin Davies; George Christ

252

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.

Vansintejan, Johan; Vandevoorde, Jan; Devroey, Dirk

2013-01-01

253

Prevalence of erectile dysfunction and its correlates in Egypt: a community-based study.  

PubMed

We evaluated the prevalence of erectile dysfunction (ED) in a cross-sectional community-based random sample of Egyptian men. ED was correlated with the socioeconomic status, risk factors and quality of life. Married men in Ismailia province were interviewed at home. Data were processed for 805 men with mean age of 43.58 y (s.d. 11.03). There is a fair correlation between ED and increasing age (< or = 0.001). Males with complete ED comprised 13.2% of the sample, 26% of men in their 50s, 49% of men in their 60s and 52% of those 70 y or older. The state of better erection correlated fairly with sexual desire and sexual satisfaction (< or = 0.01). ED was associated with living in rural areas and lower socioeconomic level (< or = 0.01), with smoking, diabetes, heart disease, hypertension, liver disease, arthritis, peptic ulcer and renal disease (< or = 0.05). ED was negatively associated with good quality of life (< or = 0.001). These results indicate that ED is a common problem among married Egyptian men. PMID:12934050

Seyam, R M; Albakry, A; Ghobish, A; Arif, H; Dandash, K; Rashwan, H

2003-08-01

254

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

PubMed Central

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

Uckert, Stefan; Assadi-Pour, Farhang; Kuczyk, Markus A.; Albrecht, Knut

2013-01-01

255

Influence of erectile dysfunction on health related quality of life of male kidney transplant patients.  

PubMed

The objective of the present study was to investigate if a psychological adaptation capacity exists in kidney transplant bearers, even with ageing, in relation to erectile dysfunction (ED). We studied ED using IIEF-5 and health-related quality of life (HRQoL) using the SF-36 Health Survey, in a large sample of male renal transplant patients (n=242), searching for the influence of ED on HRQoL. Patients included 199 patients (82%); the median age was 52 y (43-62); 106 patients (54.9%) presented ED. These patients were divided into four groups according to median age. SF-36 scores were worse for ED vs non-ED patients in the first three age groups, but not in age group 4. SF-36 Mental Component Summary was similar for patients with ED and without ED in all age groups. We confirm the hypothesis that a psychological adaptation occurs in renal transplant patients in all age groups, when suffering ED. PMID:14961058

Rebollo, P; Ortega, F; Valdés, C; Fernández-Vega, F; Ortega, T; García-Mendoza, M; Gómez, E

2004-06-01

256

The Princeton III Consensus recommendations for the management of erectile dysfunction and cardiovascular disease.  

PubMed

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

2012-08-01

257

Physicochemical stability study of a new Trimix formulation for treatment of erectile dysfunction.  

PubMed

Currently, severe erectile dysfunction can be treated by intracavernous injections of solutions containing three active ingredients: prostaglandin E1 (PGE1), papaverine and urapidil. Very few data exist on this mixture where phentolamine has been replaced by Urapidil because Phentolamine is not used for this indication in France. The aim of our study was to assess the stability of this formulation and to extend its expiration to permit preparation of batches. Three batches of the preparation containing 15?g/mL PGE1, 15mg/mL of papaverine and 2mg/mL urapidil were made aseptically and then packed in polypropylene syringes stored at 4°C. The physico-chemical stability has been tested as follows: HPLC stability-indicating method, visual observation, measurement of pH and osmolarity. We found that the limiting factor was PGE1 and we exceeded the threshold of 10% loss after 55 days. Replacement of Urapidil by Phentolamine seems to have a slight detrimental effect on stability. Nevertheless, these results allow us to consider the advance preparation of this formulation and provide quality treatment to these patients by avoiding too frequent visits to the hospital. PMID:24075706

Vieillard, V; Eychenne, N; Astier, A; Yiou, R; Deffaux, C; Paul, M

2013-08-21

258

Erectile dysfunction and lower urinary tract symptoms: a consensus on the importance of co-diagnosis.  

PubMed

Despite differences in design, many large epidemiological studies using well-powered multivariate analyses consistently provide overwhelming evidence of a link between erectile dysfunction (ED) and lower urinary tract symptoms (LUTS). Preclinical evidence suggests that several common pathophysiological mechanisms are involved in the development of both ED and LUTS. We recommend that patients seeking consultation for one condition should always be screened for the other condition. We propose that co-diagnosis would ensure that patient management accounts for all possible co-morbid and associated conditions. Medical, socio-demographic and lifestyle risk factors can help to inform diagnoses and should be taken into consideration during the initial consultation. Awareness of risk factors may alert physicians to patients at risk of ED or LUTS and so allow them to manage patients accordingly; early diagnosis of ED in patients with LUTS, for example, could help reduce the risk of subsequent cardiovascular disease. Prescribing physicians should be aware of the sexual adverse effects of many treatments currently recommended for LUTS; sexual function should be evaluated prior to commencement of treatment, and monitored throughout treatment to ensure that the choice of drug is appropriate. PMID:23617950

Kirby, M; Chapple, C; Jackson, G; Eardley, I; Edwards, D; Hackett, G; Ralph, D; Rees, J; Speakman, M; Spinks, J; Wylie, K

2013-04-25

259

Erectile dysfunction as a cardiovascular risk factor in patients with diabetes.  

PubMed

Erectile dysfunction (ED) is a highly prevalent disorder among patients with diabetes mellitus (DM). In most cases, ED is considered a vascular disease and its development is significantly related to the exposure to CVD risk factors. In this context, ED and coronary artery disease (CAD) have been proposed as different manifestations of the same systemic disease; in nondiabetic patients, ED has progressively emerged as an important sentinel marker of the subsequent onset of CVD events. The aim of this review was to evaluate the association between ED and CAD in diabetic patients and to evaluate the role of ED as an independent CVD risk factor in these patients. Three large prospective studies confirmed that ED is a powerful predictor of CAD and cardiac mortality in patients with DM. Overall, diabetic patients with ED had roughly 1.4-fold higher risk of CAD as compared with those without ED. Interestingly, in diabetic patients, CAD is often silent and CAD screening according to the current guidelines can miss up to 40 % patients with occult myocardial perfusion abnormalities. Indeed, patients with ED have higher risk of silent myocardial ischemia compared to those without ED, and when ED is added to the risk factors, it can even improve the sensitivity of screening for asymptomatic CAD. Therefore, ED should be considered an independent CVD risk factor, and it could improve the identification of diabetic patients suitable for screening, leading to an early detection of CAD, and thus potentially enhancing the therapeutic effectiveness. PMID:22948773

Gandaglia, Giorgio; Salonia, Andrea; Passoni, Niccolò; Montorsi, Piero; Briganti, Alberto; Montorsi, Francesco

2012-09-05

260

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

PubMed

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

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

1998-03-01

261

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

PubMed

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

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

2013-02-01

262

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

PubMed

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

2010-09-07

263

Pyrroloquinolone PDE5 inhibitors with improved pharmaceutical profiles for clinical studies on erectile dysfunction.  

PubMed

We previously reported a series of potent and selective pyrimidinyl pyrroloquinolone PDE5 inhibitors such as 2a for potential use in male erectile dysfunction (MED) (Sui, Z.; Guan, J.; Macielag, M. J.; Jiang, W.; Zhang, S.; Qiu, Y.; Kraft, P., Bhattacharjee, S.; John, T. M.; Craig, E.; Haynes-Johnson, D.; Clancy, J. J. Med. Chem. 2002, 45, 4094-4096). Unfortunately, the low aqueous solubility and poor oral bioavailability rendered them undesirable development candidates. To address this issue, we designed a series of analogues using two approaches: increasing the overall basicity and reducing molecular weight of the lead. Through earlier SAR studies, we discovered that the PDE5 potency of the pyrroloquinolones is insensitive to substitution on the pyrrole nitrogen. Basic functional groups such as pyridines and benzimidazoles were appended via the aromatic ring connected to the pyrrole nitrogen. Several truncated analogues were also designed and synthesized to improve oral absorption. These modifications allowed us to identify analogues with good oral bioavailability in rats, dogs, and monkeys while the high potency against PDE5 and desirable selectivity versus other PDE isozymes were maintained. Compounds R-11e and R-11l were selected as development candidates for MED and other indications. PMID:15771456

Jiang, Weiqin; Guan, Jihua; Macielag, Mark J; Zhang, Suying; Qiu, Yuhong; Kraft, Patricia; Bhattacharjee, Sheela; John, T Matthew; Haynes-Johnson, Donna; Lundeen, Scott; Sui, Zhihua

2005-03-24

264

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.

Washington, Samuel L; Shindel, Alan W

2010-01-01

265

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

PubMed

Electromyography (EMG) of the corpora cavernosa (CC-EMG) is able to record the activity of the erectile tissue during erection, and thus has been used as a diagnostic technique in patients with erectile dysfunction (ED). The present study examines the usefulness of the technique in the diagnosis of arterial ED. A cross-sectional study was made of 35 males with a mean age of 48.5 years (s.d. 11.34), referred to our center with ED for >1 year. The patients were subjected to CC-EMG and a penile Doppler ultrasound study following the injection of 20 ?g of prostaglandin E1 (PGE1). The patients were divided into three groups according to their response to the intracavernous injection of PGE1: Group 1 (adequate erection and reduction/suppression of EMG activity); Group 2 (insufficient erection and persistence of EMG activity); and Group 3 (insufficient erection and reduction/suppression of EMG activity). Patient classification according to response to the intracavernous injection of PGE1 was as follows: Group 1: six patients (17%), Group 2: 18 patients (51%), and Group 3: 11 patients (31%). Patients diagnosed with arterial insufficiency according to Doppler ultrasound (systolic arterial peak velocity <30 mm s(-1) in both arteries) were significantly older than those without such damage (54.5 versus 41.8 years, respectively; s.d. 11.12). The patients in Group 3 showed a significantly lower maximum systolic velocity in both arteries than the subjects belonging to Group 2. Likewise, a statistically significant relationship was observed between the diagnosis of arterial insufficiency and patient classification in Group 3. The confirmation of insufficient erection associated with reduction/suppression of EMG activity showed a sensitivity of 66.7% (confidence interval between 50 and 84%) and a specificity of 92.9% (confidence interval between 84 and 100%) in the diagnosis of arterial ED. Owing to the high specificity of CC-EMG response to the injection of PGE1, this test is considered useful as a screening technique in the diagnosis of arterial ED. PMID:22551823

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

2012-05-03

266

Male sexuality and regulation of emotions: a study on the association between alexithymia and erectile dysfunction (ED).  

PubMed

Alexithymia is a multidimensional construct that describes a constellation of personality features characterised by difficulties in differentiating, identifying and communicating emotions. The purpose of the present study was to investigate prevalence of alexithymia in outpatients with erectile dysfunction (ED), both in the psychogenic lifelong type (PLED) and in the acquired one (PAED). ED severity was evaluated with the International Index of Erectile Function (IIEF) and alexithymia was measured using the Italian version of the 20-item Toronto Alexithymia Scale (TAS-20). The results suggest a high incidence of alexithymic characteristics in patients with psychogenic ED, a positive correlation between the alexithymia level and ED severity in patients with PAED and statistically significant differences in the alexithymia level between the two subgroups PLED and PAED. We assumed that alexithymia contributes to the origin of the PLED, and to a more severe manifestation of ED, once it appears in the acquired form. PMID:16151475

Michetti, P M; Rossi, R; Bonanno, D; Tiesi, A; Simonelli, C

267

Intracavernous self-injection of prostaglandin E1 in the treatment of erectile dysfunction.  

PubMed

In a three-year follow-up study of 69 patients found that erectile dysfunction (ED) impairs many elderly men's life: up to 25% of the men aged 65 y and 80% of those aged 75 y suffer from erectile dysfunction. The most effective non-surgical treatment of ED is intracavernosal pharmacotherapy, and the most common vasoactive agent currently used is prostaglandin E1 (PGE1). The purpose of this study was to assess the long-term outcome of PGE1 treatment and the patients' overall satisfaction with their sexual life. Sixty-nine patients who had started ICI therapy three years earlier were invited to a control examination. The mean age of the patients was 60.5 y. The patients filled in a questionnaire, which included questions about the use of PGE1 treatment at home. All the patients evaluated their own satisfaction with their erection, ejaculation, orgasm and libido on a visual analytical scale (VAS, 0-100%). A clinical examination was made, and the penile shaft was examined by ultrasonography. Erection with the home dose of PGE1 was estimated by Rigiscan, and the degree of erection was also estimated clinically (grades 0-5) by a doctor. The most common doses of PGE1 used at home were between 10 and 20 m (58%), 46.4% of the patients had discontinued PGE1 therapy, the mean time of using PGE1 was 23.3 months. The mean coital frequency with PGE1 was 2.8 times per month. 34.8% of the patients (24 out of 69) reported that their own spontaneous erections had improved after the beginning of PGE1 therapy. The most common problem was hematomas in 10.1% of the patients (7 out of 69), which, however, were small and did not cause discontinuation of the therapy. There were three instances of priapism (4.3%), and four patients (5.8%) had fibrosis in ultrasonography. The patients' satisfaction with their erection at home was 67.3% with PGE1. The mean coital frequency with PGE1 therapy was quite low, 2.8 times per month, even though the patients' mean age was only 60.5 y, one reason may be the high price of PGE1 injections. The rate of improvement of spontaneous erections while using PGE1 was quite high, accounting for 34.8% of the patients. Most of the patients who discontinued the PGE1 therapy had a psychogenic etiology. There were no systemic side-effects with PGE1. Only 7.2% of the patients had prolonged pain after the injection, leading to drug discontinuation. It can be concluded that treatment with intracavernous injections of PGE1 is well tolerated and involves only minor problems. The patients' satisfaction with their erections at home with PGE1 therapy was good. Precise determination of the home dose of PGE1 and the teaching of the technique of injection are important at the beginning of this treatment modality. PMID:10098949

Kunelius, P; Lukkarinen, O

1999-02-01

268

Herpes simplex virus infection and erectile dysfunction: a nationwide population-based study.  

PubMed

Both erectile dysfunction (ED) and herpes simplex virus (HSV) infections are related to cardiovascular events. However, the relationship between ED and HSV infections remains undetermined. The aim of our study was to investigate the possible influence of HSV infections on the development of ED using the Taiwan National Health Insurance database. We identified patients with HSV type 1 or type 2 infections from the 1 000 000 sampling cohort data set. Male patients of age 18 years or older who had been diagnosed as cases of HSV infection since January 1, 2001 were enroled. Patients with previous history of stroke, spinal cord injury or malignancy were excluded. A control group was selected, comprising male patients without HSV infection, stroke, spinal cord injury or malignancy. The age, time of enrolment and comorbidities were matched in the two groups. A total of 1 717 HSV subjects (mean age 43.29 ± 15.97 years) and 6 864 control subjects were enroled. During an average of 3.91 ± 1.93 years' follow-up, HSV-infected subjects experienced a higher incidence of ED than control subjects (1.7% vs. 0.7%, respectively). The log-rank test showed that patients with HSV infections had a significantly higher incidence of ED than those without HSV infections (p < 0.001). After Cox proportional hazard regression model analysis, HSV infections were independently associated with the increased risk of ED (hazard ratio, 2.90; 95% CI, 1.82-4.63, p < 0.001). In conclusion, HSV infections were associated with risk of ED in this cohort. PMID:23413136

Huang, C-C; Chan, W-L; Chen, Y-C; Chen, T-J; Chung, C-M; Huang, P-H; Lin, S-J; Chen, J-W; Leu, H-B

2012-12-14

269

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

270

A Mouse Model of Erectile Dysfunction Via Diet-Induced Diabetes Mellitus  

PubMed Central

Objective Diabetes mellitus (DM) is a significant risk factor in the development of erectile dysfunction (ED). We sought to determine whether diet induced DM in mice would recapitulate the major features of human ED. Methods In total, 150 C57BL6 (bl-6) mice were divided into 6 groups (n=25/group). One hundred twenty five were fed a high fat (45% total calories) diet for the final 4 (Group 2), 8 (Group 3), 12 (Group 4),16 (Group 5), or 22 (Group 6) weeks. Group 1 was fed a normal diet. Mice were 22-25 weeks old at study termination. Corporal tissues were harvested and studied for a) endothelium-dependent and endothelium-independent vasoreactivity, b) endothelial and smooth muscle cell content by immunohistochemistry, c) NOS expression by NADPH-diaphorase staining. d) Apoptosis by TUNEL staining. Results Blood glucoses were greater in Groups 2 -6 vs. Group 1. Vasoreactivities, endothelial cell content, smooth muscle/collagen ratio were lower while apoptosis was higher in the DM mice (p=0.0001, p=0.10, p=0.0002, p<0.001, p<0.001, respectively). There was significant decreased NOS expression and significant increase in apoptosis (p<0.0001 each) in high fat dieted mice. Conclusions Corporal tissue from mice with diet induced DM demonstrate many of the major functional, structural, and biochemical changes found in humans with ED. This model should serve as a valuable tool for advancing our understanding the role DM plays in the pathogenesis of ED.

Xie, Donghua; Odronic, Shelley I.; Wu, Feihua; Pippen, Anne; Donatucci, Craig F.; Annex, Brian H.

2007-01-01

271

Molecular mechanisms of detrusor and corporal myocyte contraction: identifying targets for pharmacotherapy of bladder and erectile dysfunction  

PubMed Central

The Post-Genomic age presents many new challenges and opportunities for the improved understanding, diagnosis and treatment of human disease. The long-term goal is to identify molecular correlates of disease processes, and use this information to develop novel and more effective therapeutics. A major hurdle in this regard is ensuring that the molecular targets of interest are indeed relevant to the physiology and/or pathophysiology of the processes being studied, and, moreover, to determine if they are specific to the tissue/organ being investigated. As a first step in this direction, we have reviewed the literature pertaining to bladder and erectile physiology/pharmacology and dysfunction and attempted to summarize some of the critical molecular mechanisms regulating detrusor and corporal myocyte tone. Because of the vast amount of published data, we have limited the scope of this review to consideration of the calcium-mobilizing and calcium-sensitizing pathways in these cells. Despite obvious differences in phenotypic characteristics of the detrusor and corporal myocyte, there are some common molecular changes that may contribute to, for example, the increased myocyte contractility characteristic of bladder and erectile dysfunction (i.e. increased Rho kinase activity and decreased K+ channel function). Of course, there are also some important distinctions in the pathways that modulate contractility in these two cell types (i.e. the contribution of ryanodine-sensitive calcium stores and the nitric oxide/cGMP pathways). This report highlights some of these similarities and distinctions in the hope that it will encourage scientific discourse and research activity in this area, eventually leading to an improved quality of life for those millions of individuals that are afflicted with bladder and erectile dysfunction.

Christ, George J; Hodges, Steve

2006-01-01

272

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

PubMed Central

Emperor Shen-Nung was the second of China's mythical emperors (3500-2600 BCE). Widely considered the father of Chinese medicine, he catalogued over 365 species of medicinal plants which he personally tasted. Through his treatise ‘Shen Nung Benchau Jing’, we relive Emperor Shen-Nung's contribution to urology with reference to his management of erectile dysfunction. Time-related sources in medical and historical literature were reviewed, including the ‘Shen Nung Benchau Jing’ (The medicine book of Emperor Shen-Nung), archives and manuscripts at the Wellcome History of Medicine Collection, the Royal Society of Medicine, London, The Hong Kong Museum of Medical Sciences, and The Museum of Medical History, Shanghai, China. Chinese traditional herbal medicine began approximately 5000 years ago. Agricultural clan leader, Emperor Shen-Nung, was said to have a ‘crystal-like belly’ to watch the reactions in his own stomach of the herbs he collected. Ginseng was among of Shen Nung's contributions to herbal medicine. He experienced a warm and sexually pleasurable feeling after chewing the root. He advocated this as a treatment for erectile dysfunction and used it to stimulate sexual appetite. The reputation of ginseng as an aphrodisiac is based on the doctrine of signatures, since the adult root has a phallic shape. Shen-Nung believed that ginseng's resemblance to the human form is proof of its rejuvenative and aphrodisiac properties. It was believed that the closer the similarity to the human figure, the more potent the root. The use of ginseng for erectile dysfunction by Emperor Shen-Nung was unique for its time. It continues to hold parallels as a modern-day herbal aphrodisiac 5000 years on.

Nair, Rajesh; Sellaturay, Senthy; Sriprasad, Seshadri

2012-01-01

273

Clinical safety profile of sildenafil in Singaporean men with erectile dysfunction: pre-marketing experience (ASSESS-I evaluation).  

PubMed

Safety and tolerability of sildenafil citrate was assessed in a population subset of 60 Singaporean men with erectile dysfunction taken from the Asian Sildenafil Efficacy and Safety Study (ASSESS-I), a double-blind, placebo-controlled, flexible-dose study. The men, from two centres, with > or = 6 months' history of erectile dysfunction, were randomized to two treatment arms for 12 weeks. One group (30 patients) received sildenafil (initial dose 50 mg taken 1 h before sexual activity for the first 2 weeks, increased to 100 mg or decreased to 25 mg, according to efficacy and/or tolerability). The remaining 30 patients received a matching placebo. Incidence and type of adverse effects were evaluated at 2, 4, 8 and 12 weeks. Nine patients (30.0%) on sildenafil (33.1% in the full ASSESS-I study) and one patient (3.3%) on placebo (22.8% in the full ASSESS-I study) experienced treatment-related adverse events, the most frequent being headache in the sildenafil group (reported by five patients [16.7%]; 11.0% in the full ASSESS-I study). Flushing, visual disturbance, dizziness, insomnia, myalgia and back pain each occurred in one patient in the sildenafil group (3.3%); in the placebo group, one patient (3.3%) had headache. Importantly, the incidence of cardiovascular and respiratory system adverse events were relatively less than in the full ASSESS-I population (cardiovascular 3.3% in the present study versus 10.2% in the full ASSESS-I population; respiratory 3.3% versus 5.5%). All adverse events were transient and mild, and did not lead to treatment withdrawal. There was no effect on sitting blood pressure, heart rate or standard laboratory parameters; more importantly, there was no incidence of myocardial infarction, stroke or priapism. These results should reassure Singaporean patients and their physicians of the safety of sildenafil for erectile dysfunction. PMID:12025521

Lim, P H C; Ng, F C; Cheng, C W S; Wong, M Y C; Chee, C T Y; Moorthy, P; Vasan, S S

274

Body mass index, physical activity and erectile dysfunction: An U-shaped relationship from population-based study  

Microsoft Academic Search

Objective:To investigate the relationships between body mass index (BMI), physical activity and erectile dysfunction (ED).Design and subjects:A population representative cross-sectional analytic study of ED in Hong Kong, with two-stage stratified random sampling, and face-to-face interviews conducted by trained interviewers with structured questionnaires. Study subjects were 1506 men aged 26–70.Results:Age (odds ratio (OR)=1.30; 95% confidence interval (CI) 1.20–1.40), physical activity (OR=0.91

J Y W Cheng; E M L Ng; JYW Cheng

2007-01-01

275

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

276

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

277

Erectile Dysfunction and Cardiovascular Events in Diabetic Men: A Meta-analysis of Observational Studies  

PubMed Central

Background Several studies have shown that erectile dysfunction (ED) influences the risk of cardiovascular events (CV events). However, a meta-analysis of the overall risk of CV events associated with ED in patients with diabetes has not been performed. Methodology/Principal Findings We searched MEDLINE and the Cochrane Library for pertinent articles (including references) published between 1951 and April 22, 2012. English language reports of original observational cohort studies and cross-sectional studies were included. Pooled effect estimates were obtained by random effects meta-analysis. A total of 3,791 CV events were reported in 3 cohort studies and 9 cross-sectional studies (covering 22,586 subjects). Across the cohort studies, the overall odds ratio (OR) of diabetic men with ED versus those without ED was 1.74 (95% confidence interval [CI]: 1.34–2.27; P<0.001) for CV events and 1.72 (95% CI: 1.5–1.98; P<0.001) for coronary heart disease (CHD). The funnel plot, Begg's test, and Egger's test did not show evidence of publication bias (all P>0.05). Moreover, meta-regression analysis found no relationship between the method used to assess ED (questionnaire or interview), mean age, mean hemoglobin A1c, mean body mass index, or mean duration of diabetes and the risk of CV events or CHD. In the cross-sectional studies, the OR of diabetic men with ED versus those without ED was 3.39 (95% CI: 2.58–4.44; P<0.001) for CV events (N?=?9), 3.43 (95% CI: 2.46–4.77; P<0.001) for CHD (N?=?7), and 2.63 (95% CI: 1.41–4.91; P?=?0.002) for peripheral vascular disease (N?=?5). Conclusion/Significance ED was associated with an increased risk of CV events in diabetic patients. Prevention and early detection of cardiovascular disease are important in the management of diabetes, especially in view of the rapid increase in its prevalence.

Yamada, Tomohide; Hara, Kazuo; Umematsu, Hitomi; Suzuki, Ryo; Kadowaki, Takashi

2012-01-01

278

Aging respectably by rejecting medicalization: Mexican men's reasons for not using erectile dysfunction drugs.  

PubMed

As lifestyle drug production and medical interest in geriatrics increase, the medicalization of aging and sexuality have become intertwined. Drugs like Viagra naturalize lifelong performance of phallocentric sex as a marker of healthy aging. Yet despite the ubiquity of medical aids for having "youthful" sex in older age, this article argues that having no or less sex can be a conscious strategy for embodying respectable aging. Based on ethnographic research in a Cuernavaca, Mexico, hospital urology department, this article shows that despite the traditional association of penetrative sex with successful masculinity, many older, working-class Mexican men faced with erectile difficulty reject "youthful" sexuality and drugs that facilitate it in order to embody a "mature" masculinity focused on home and family. This article argues that social encouragement and structural disincentives for medicalizing erectile difficulty encouraged men to interpret decreasing erectile function as natural and appropriate. PMID:23674320

Wentzell, Emily

2013-03-01

279

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.

Djordjevic, Miroslav L; Kojovic, Vladimir

2013-01-01

280

[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

281

Prevalence of erectile dysfunction among Chinese men with type 2 diabetes mellitus  

Microsoft Academic Search

The aims of this study were to investigate the prevalence of ED in Chinese men with type 2 diabetes mellitus, and evaluate the efficacy and safety of sildenafil citrate in these patients. Patients from 42 outpatient diabetes clinics with type 2 diabetes mellitus and ED as defined by the International Index of Erectile Function (IIEF)-5 were studied. Participants with ED

G Yang; C Pan; J Lu

2010-01-01

282

Efficacy and safety of tadalafil taken as needed for the treatment of erectile dysfunction in Asian men: results of an integrated analysis  

Microsoft Academic Search

We evaluated the efficacy and safety of as-needed tadalafil in a diverse clinical population (with varying patient demographics, disease severity, and comorbid medical conditions) of Asian men with erectile dysfunction (ED). An integrated analysis of five double-blind, placebo-controlled trials (N = 1 046) was performed. Patients were randomly assigned to receive 10 mg tadalafil (N = 185), 20 mg tadalafil

Ying-Lu Guo; Vijay P Viswanathan; Han-Sun Chiang; Hyung Ki Choi; Andrew Wai Chun Yip; Wei Shen; Vladimir Kopernicky

2009-01-01

283

Comparison of transdermal nitroglycerin and intracavernous injection of papaverine in the treatment of erectile dysfunction in patients with spinal cord lesions  

Microsoft Academic Search

This study was done to evaluate the effectiveness of transdermal nitroglycerin in the treatment of erectile dysfunction in males with spinal cord lesions as compared to the treatment with intracavernous injection of papaverine. The study design used was an open, randomized, cross over trial of intracavernous injection papaverine versus transdermal nitroglycerin. Twenty eight male patients with spinal cord lesions with

R Renganathan; B Suranjan; T Kurien

1997-01-01

284

Early sildenafil dose optimization and personalized instruction improves the frequency, flexibility, and success of sexual intercourse in men with erectile dysfunction  

Microsoft Academic Search

We investigated the effect of early sildenafil dose optimization and personalized instructions on sexual intercourse success in 1109 men beginning sildenafil therapy for erectile dysfunction. In phase 1 (4 weeks), patients followed the instructions contained in the sildenafil (50 mg) sample pack and had 1.4 sexual intercourse attempts per week with 82% success. Patients (17%) had a second intercourse attempt

C P Steidle; A R McCullough; J C Kaminetsky; A R Crowley; R L Siegel; H deRiesthal; L-J Tseng

2007-01-01

285

Comparison of a needle-free high-pressure injection system with needle-tipped injection of intracavernosal alprostadil for erectile dysfunction  

Microsoft Academic Search

Patients identified from hospital records as using alprostadil injections for erectile dysfunction were invited to take part in this open crossover study. On alternate weeks eight patients were given intracavernosal needle injections and transdermal needle-free injection of alprostadil in a randomized order. Efficacy of injection and associated pain were assessed and compared for the two methods. Pain produced during injection

L M Harding; A Adeniyi; R Everson; S Barker; D J Ralph; A P Baranowski

2002-01-01

286

Effects of Intravenous Injection of Adipose-Derived Stem Cells in a Rat Model of Radiation Therapy-Induced Erectile Dysfunction  

PubMed Central

Introduction Radiation therapy (RT) for prostate cancer is frequently associated with post-treatment erectile dysfunction (ED). Aim To investigate whether injection of adipose-derived stem cells (ADSCs) can ameliorate RT-associated ED. Methods Thirty male rats were divided into 3 groups. The Control+PBS group received tail-vein injection of phosphate-buffered saline (PBS). The Radiation+PBS group received radiation over the prostate and tail-vein injection of PBS. The Radiation+ADSC group received radiation over the prostate and tail-vein injection of ADSCs, which were labeled with 5-ethynyl-2-deoxyuridine (EdU). Seventeen weeks later erectile function was evaluated by intracavernous pressure (ICP) in response to electrostimulation of cavernous nerves (CN). Penile tissue and major pelvic ganglia (MPG) were examined by immunofluorescence (IF) and EdU staining. Main Outcome Measures Erectile function was measured by ICP. Protein expression was examined by IF, followed by image analysis and quantification. Results Radiation over the prostate caused a significant decrease in erectile function and in the expression of neuronal nitric oxide synthase (nNOS) in penis and MPG. Cavernous smooth muscle (CSM) but not endothelial content was also reduced. Injection of ADSCs significantly restored erectile function, nNOS expression, and CSM content in the irradiated rats. EdU-positive cells were visible in MPG. Conclusions Radiation appears to cause ED via CN injury. ADSC injection can restore erectile function via CN regeneration.

Qiu, Xuefeng; Villalta, Jacqueline; Ferretti, Ludovic; Fandel, Thomas M; Albersen, Maarten; Lin, Guiting; Dai, Yutian; Lue, Tom F.; Lin, Ching-Shwun

2012-01-01

287

Adjunctive treatment with lodenafil carbonate for erectile dysfunction in outpatients with schizophrenia and spectrum: a randomized, double-blind, crossover, placebo-controlled trial.  

PubMed

INTRODUCTION.: Evidence is accumulating to support the presence of erectile dysfunction in patients with schizophrenia. This dysregulation may be amenable to therapeutic intervention to improve adherence and quality of life of patients who suffer from schizophrenia and schizoaffective disorders. AIM.: We aimed to evaluate the use of adjunctive medication lodenafil for the treatment of erectile dysfunction in outpatients with schizophrenia and spectrum. METHODS.: The design was a randomized, double-blind, crossover, placebo-controlled trial with lodenafil and it was carried at the Schizophrenia Outpatients Program. MAIN OUTCOME MEASURES.: The measures used to assess sexual dysfunction were Arizona Sexual Experiences Scale (ASEX) and International Index of Erectile Function (IIEF). The Positive and Negative Syndrome Scale (PANSS) and the Quality of Life Scale (QLS) were also used. The measures included the levels of prolactin, estradiol, luteinizing hormone, sex hormone-binding globulin, free testosterone, and total testosterone at baseline and end point. Lodenafil and placebo pills were used by the patients for 16 weeks. RESULTS.: Fifty male outpatients fulfilled the criteria and 94% of the participants completed the study. Lodenafil and placebo produced improvement in ASEX, IIEF scale, PANSS, and QLS, and there was no statistical difference between lodenafil and placebo groups in all sexual domains in the results of PANSS and QLS and in the results of hormone levels. CONCLUSION.: These results indicate that both lodenafil and placebo were effective in the treatment of erectile dysfunction for schizophrenia. Placebo effect is very important in patients with schizophrenia and this study showed the importance of discussing sexuality and trying to treat these patients. Further studies designed to test treatments of erectile dysfunction in patients who suffer from schizophrenia are necessary. PMID:23350632

Nunes, Luciana Vargas Alves; Lacaz, Fernando Sargo; Bressan, Rodrigo Affonseca; Nunes, Sandra Odebrecht Vargas Alves; Mari, Jair de Jesus

2013-01-25

288

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.

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

289

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

PubMed Central

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

Raheem, Amr Abdel; Kell, Philip

2009-01-01

290

The impact of the use of PDE5 inhibitors for erectile dysfunction on the lives of Australian men.  

PubMed

This article presents findings from a recent cross-sectional study that was designed to evaluate both the impact of erectile dysfunction (ED) on the lives of Australian men, and explore whether the use of PDE5 inhibitors was able to alter this impact. The sample comprised 410 men with ED, and 242 men who did not have ED. All men were primarily recruited over the internet via men's health web sites. Participants completed a questionnaire to assess their self-esteem, masculinity, quality of life, sexual satisfaction, relationship satisfaction and usage of oral ED medication. The results demonstrated that men with ED experienced deficits on all of the psychosocial areas when compared to men without ED. Moreover, treatment with ED medication did not alleviate this deficit. Implications of these findings for the treatment of men with ED are discussed in the context of the biopsychosocial model of health and the need for a multidisciplinary approach to ED management is highlighted. PMID:17538638

Matic, H; McCabe, M P

2007-05-31

291

Erectile Dysfunction Drug Receipt, Risky Sexual Behavior and Sexually Transmitted Diseases in HIV-infected and HIV-uninfected Men  

Microsoft Academic Search

BACKGROUND  Health care providers may be concerned that prescribing erectile dysfunction drugs (EDD) will contribute to risky sexual behavior.\\u000a \\u000a \\u000a \\u000a OBJECTIVES  To identify characteristics of men who received EDD prescriptions, determine whether EDD receipt is associated with risky\\u000a sexual behavior and sexually transmitted diseases (STDs), and determine whether these relationships vary for certain sub-groups.\\u000a \\u000a \\u000a \\u000a \\u000a DESIGN  Cross-sectional study.\\u000a \\u000a \\u000a \\u000a PARTICIPANTS  Two thousand seven hundred and eighty-seven sexually-active,

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

2010-01-01

292

Twelve-month comparison of two treatments for erectile dysfunction: self-injection versus external vacuum devices.  

PubMed

This study directly compared two nonsurgical treatments for erectile dysfunction, self-injection of papaverine/phentolamine and external vacuum devices, in terms of usage rates, effectiveness, side effects, dropout rates, and impact on patient sexual and psychologic functioning. Both alternatives were regularly, successfully, and safely used by patients, though dropout rates were higher for self-injection. Both produced erections of improved quality, and effected sustained improvements in frequency of intercourse, orgasm, and sexual satisfaction. Spontaneous erections also improved with both treatments. General psychiatric symptomatology was decreased, and anxiety was improved. There were no differences between the two treatments in sexual or psychologic impact. Relative contraindications and esthetic considerations are presented. PMID:1736506

Turner, L A; Althof, S E; Levine, S B; Bodner, D R; Kursh, E D; Resnick, M I

1992-02-01

293

Raising awareness for the diagnosis and treatment of erectile dysfunction in patients with high risk to develop ED.  

PubMed

Prevalence of erectile dysfunction (ED) increases with age and is associated with chronic comorbidities, such as diabetes and hypertension. Even so, ED is underdiagnosed and undertreated. This study investigated the effect of raising awareness of ED diagnosis and treatment in a community setting by physicians' education. Thirty-nine primary care physicians participated in lectures by a trained sexologist, and 20 of them also received computerized lists of their high-risk patients. We matched a control group of 39 primary care physicians who did not receive the intervention; we thus followed 1959 patients in both intervention groups and 1903 patients in the control group. During the period of 6 months before the intervention and 6 months after the intervention, no significant differences were found between the groups in diagnosis of new ED patients, in phosphodiesterase-5 inhibitor prescriptions or in referrals to urologists. We therefore suggest that sporadic lectures and computerized patient lists do not significantly affect the physician's behavior. PMID:19440197

Azuri, J; Gelerenter, R; Dushinat, M; Friedman, N; Kokia, E

2009-05-14

294

Erectile dysfunction and later cardiovascular disease in men with type 2 diabetes: prospective cohort study based on the ADVANCE (Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified-Release Controlled Evaluation) trial  

Microsoft Academic Search

OBJECTIVES: The aim of this study was to examine the relationship between erectile problems in men and cardiovascular disease (CVD) mortality. BACKGROUND: Although there are plausible mechanisms linking erectile dysfunction (ED) with coronary heart disease (CHD) and stroke, studies are scarce. METHODS: In a cohort analysis of the ADVANCE (Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified-Release Controlled

G. D. Batty; Q. Li; S. Czernichow; B. Neal; S. Zoungas; R. Huxley; A. Patel; B. E. de Galan; M. Woodward; P. Hamet; S. B. Harrap; N. Poulter; J. Chalmers

2010-01-01

295

Redefining the role of long-acting phosphodiesterase inhibitor tadalafil in the treatment of diabetic erectile dysfunction.  

PubMed

Diabetes mellitus (DM) is an established risk factor predisposing to male erectile dysfunction (ED), and it has been calculated that more than 50% of diabetic men develop ED within ten years of diagnosis. It has been suggested that the risk of ED increases with metabolic indices of inadequate diabetes control and with a longer duration of disease. Loss of the functional integrity of the endothelium and subsequent endothelial dysfunction plays an integral role in the pathogenesis of diabetic ED. Coronary and peripheral atherosclerosis are frequent complications of DM and diabetic patients have an increased risk of future cardiovascular events comparable to that of patients with coronary artery disease. The prolonged half-life of tadalafil (17.5 hours) and its prolonged period of responsiveness (36-hours), constitute an ideal pharmacokinetic profile for once-a-day dosing and makes it an ideal candidate for rehabilitative therapy in DM patients, whereas a poor compliance with on-demand schedule is reported. The aim of this review will be to give an update on clinical overall efficacy and safety of tadalafil trials, i.e in diabetic population, and finally provide evidences for redefining the role of chronic treatment in selected group of patients. PMID:18220692

Bruzziches, Roberto; Greco, Emanuela A; Pili, Marcello; Francomano, Davide; Spera, Giovanni; Aversa, Antonio

2008-02-01

296

The association of smoking and erectile dysfunction: results from the Fangchenggang Area Male Health and Examination Survey (FAMHES).  

PubMed

To describe the prevalence of erectile dysfunction (ED) and its association with smoking and other risk factors among a large male population. Data were collected from 2686 men attending the Fangchenggang Area Male Health and Examination Survey from September 2009 to December 2009. ED was assessed using the 5-item International Index of Erectile Function. Self-reported smoking history was obtained from the questionnaire. Prevalence of ED was 49.5% among 2686 Chinese men in Fangchenggang aged 20-79 years. After adjusting for age, alcohol drinking, physical activity, hypertension, diabetes, dyslipidemia, and obesity, smokers who smoked ?20 cigarettes daily had a significantly increased risk of ED than never smokers (odds ratio [OR], 1.23; 95% confidence interval [CI], 1.03-1.49; P = .02). After further adjustment for education, the risk of ED was still significantly higher in men smoking more than 23 years than never smokers (OR, 1.60; 95% CI, 1.22-2.09; P = .001). Association of age and education with ED was statistically significant after adjusting for the other variables. A history of diabetes and hypertension all increased the risk of ED, but statistically significant differences did not exist after adjustment for other variables. The association between smoking and ED risk in men was higher with a habit of drinking alcohol (OR, 1.32; 95% CI, 1.01-1.74) or physical inactivity (OR, 1.33; 95% CI, 1.05-1.67), or with a with a history of hypertension (OR, 1.71; 95% CI, 1.11-2.62), dyslipidemia (OR, 1.39; 95% CI, 1.06-1.81), and diabetes (OR, 2.69; 95% CI, 1.4-6.98). Our results show that heavy smoking might cause ED and that the duration of the habit increases the risk of ED. Furthermore, it highlights the potential interaction of smoking with other life habits or medical history on ED risk. PMID:21436308

Wu, Chunlei; Zhang, Haiying; Gao, Yong; Tan, Aihua; Yang, Xiaobo; Lu, Zheng; Zhang, Youjie; Liao, Ming; Wang, Mengjie; Mo, Zengnan

2011-03-24

297

The Cumulative Effects of Medication Use, Drug Use, and Smoking on Erectile Dysfunction Among Men Who Have Sex With Men  

PubMed Central

Introduction Erectile dysfunction (ED) is highly prevalent among Human Immunodeficiency Virus-seropositive (HIV+) men who have sex with men (MSM). There is a need for additional research to determine the correlates of HIV+ and HIV-seronegative (HIV?) MSM, especially regarding non-antiretroviral medication use. Aims This study examined the prevalence of ED and the socio-demographic, medical conditions, medication use, and substance use correlates of ED among HIV+ and HIV? MSM. Methods A modified version of the International Index of Erectile Function (IIEF) for MSM was self-administered by participants enrolled in the Multicenter AIDS Cohort Study (MACS), an ongoing prospective study of the natural and treated histories of HIV infection among MSM in the United States. The study sample included 1,340 participants, including 612 HIV+ and 728 HIV? men. Poisson regression with robust error variance was used to estimate prevalence ratios of ED in multivariable models in combined (HIV+/?) and separate analyses. Main outcome measure ED was determined by the summed scores of a modified version of the IIEF validated among MSM. Results Twenty-one percent of HIV+ MSM and 16% of HIV? MSM reported ED. Being >55 years of age, Black race, cumulative pack-years of smoking, cumulative antihypertensive use, and cumulative antidepressant use had significant positive associations with the prevalence of ED in the total sample. Among HIV+ men, duration of antihypertensive use and antidepressant use were significantly associated with increasing prevalence of ED. Among HIV? men, being >55 years of age, Black race, and cigarette smoking duration were associated with increased prevalence of ED. Conclusion Predictors of ED may differ by HIV status.. Although smoking cessation and effective medication management may be important as possible treatment strategies for ED among all MSM, there may be a burden on sexual functioning produced by non-HIV medications for HIV+ men.

Hart, Trevor A.; Moskowitz, David; Cox, Christopher; Li, Xiuhong; Ostrow, David G.; Stall, Ron D.; Gorbach, Pamina M.; Plankey, Michael

2012-01-01

298

Efficacy and Safety of a Novel Combination of L-Arginine Glutamate and Yohimbine Hydrochloride: A New Oral Therapy for Erectile Dysfunction  

Microsoft Academic Search

Purpose: The goal of this double-blind, placebo-controlled, three-way crossover, randomized clinical trial was to compare the efficacy and safety of the combination of 6g of L-arginine glutamate and 6mg of yohimbine hydrochloride (AY) with that of 6mg of yohimbine hydrochloride (YP) alone and that of placebo (PP) alone, for the treatment of erectile dysfunction (ED).Materials and Methods: Forty-five patients were

Thierry Lebret; Jean-Marie Hervé; Philippe Gorny; Manuel Worcel; Henry Botto

2002-01-01

299

Evaluation of oral Ro70-0004\\/003, an ?1A-adrenoceptor antagonist, in the treatment of male erectile dysfunction  

Microsoft Academic Search

?-Adrenoceptor antagonists have been used for the treatment of male erectile dysfunction (MED). Ro70-0004\\/003 (Ro70-0004) is a selective and orally active ?1A-adrenoceptor antagonist. The objective of this study was to: (1) pharmacologically elucidate the ?1-adrenoceptor subtype mediating norepinephrine-induced contraction of human isolated corpus cavernosal tissue and (2) conduct a clinical proof-of-concept study with Ro70-0004 to test the hypothesis that selective

A Choppin; Blue; SS Hegde; D Gennevois; SA McKinnon; A Mokatrin; TJ Bivalacqua; WJG Hellstrom

2001-01-01

300

Axial penile rigidity as primary efficacy outcome during multi-institutional in-office dose titration clinical trials with alprostadil alfadex in patients with erectile dysfunction  

Microsoft Academic Search

The purpose of the study was to utilize axial penile buckling testing as a primary efficacy variable of erection quality during multi-institutional in-office dose titration testing with alprostadil alfadex, prostaglandin E1 (PGE1)-?-cyclodextrin, (EDEX®\\/VIRIDAL®, Schwarz Pharma) in patients with erectile dysfunction.In 41 study sites, in three different dose titration studies involving 894 patients with impotence >6 months, a buckling test was

I Goldstein; S Auerbach; H Padma-Nathan; J Rajfer; W Fitch; L Schmitt

2000-01-01

301

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

302

A dose-response study of alprostadil sterile powder (S.Po.) (Caverject®) for the treatment of erectile dysfunction in Korean and Indonesian men  

Microsoft Academic Search

This open-label, dose-escalation study investigated the efficacy and safety of alprostadil (PGE1, prostaglandin E1) Sterile Powder (S.Po.) (Caverject®) for treatment of erectile dysfunction (ED) in 84 men with ED of various etiologies lasting ?4 months. Doses started with 2.5 µg, then 5 µg, 10, 15, 20, 30, up to a 40 µg maximum. Eligible patients received single alprostadil injections in

HK Choi; A Adimoelja; SC Kim; DM Soebadi; DH Seong; RJ Garceau

1997-01-01

303

Transurethral Alprostadil with MUSETM (medicated urethral system for erection) vs intracavernous Alprostadil—a comparative study in 103 patients with erectile dysfunction  

Microsoft Academic Search

A comparative study in 103 unselected patients with erectile dysfunction between MUSETM up to 1000 ?g and intracavernous Alprostadil (ProstavasinTM) up to 20 ?g provided total response-rates of 43% (MUSETM) vs 70% (ProstavasinTM). Complete rigid erections were reached in 10% (MUSETM) vs 48% (ProstavasinTM). The average end-diastolic flow values in the deep penile arteries ranged between 9.2–9.4 cm\\/s after MUSETM

H Porst

1997-01-01

304

Cavernosal arterial insufficiency is a major component of erectile dysfunction in some recipients of high-dose chemotherapy\\/chemo-radiotherapy for haematological malignancies  

Microsoft Academic Search

We studied 24 male patients aged 26–62 years (median 41) prospectively presenting over a 5 year period with clinical features of hypogonadism and erectile dysfunction (ED), who had been treated with autologous or allogeneic bone marrow\\/stem cell transplant for a variety of haematological malignancies and had received either high-dose chemotherapy or high-dose chemotherapy combined with total body irradiation (TBI). Ten

R Chatterjee; HO Andrews; HH McGarrigle; PD Kottaridis; WR Lees; S Mackinnon; DJ Ralph; AH Goldstone

2000-01-01

305

Condom attitudes of heterosexual men ages 50 and older using prescribed drugs (viagra, cialis, levitra) to treat erectile dysfunction.  

PubMed

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

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

2013-04-25

306

ORIGINAL RESEARCH—ERECTILE DYSFUNCTION Cutting Off the Nose to Save the Penis  

Microsoft Academic Search

Introduction. The average bicycle police officer spends 24 hours a week on his bicycle and previous studies have shown riding a bicycle with a traditional (nosed) saddle has been associated with urogenital paresthesia and sexual dysfunction. Aim. The objective of this study was to assess the effectiveness of the no-nose bicycle saddle as an ergonomic intervention and their acceptance among

Steven M. Schrader; Michael J. Breitenstein; Brian D. Lowe

307

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

PubMed

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

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

2012-02-23

308

Central nervous system-acting agents and the treatment of erectile and sexual dysfunction  

Microsoft Academic Search

Recent animal studies have resulted in newer central nervous system (CNS)-acting agents for the treatment of sexual dysfunction\\u000a in men and women. CNS stimulation and control of sexual function primarily originates in the hypothalamus, medial preoptic\\u000a area, and paraventricular nucleus. Neurotransmitters responsible for sexual function, such as serotonin, dopamine, and oxytocin,\\u000a can be manipulated pharmacologically. Early clinical trials and use

Culley C. Carson III

2007-01-01

309

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

PubMed Central

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

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

2009-01-01

310

Frequency of sexual activity and cardiovascular risk in subjects with erectile dysfunction: cross-sectional and longitudinal analyses.  

PubMed

Erectile dysfunction (ED) is risk factor for cardiovascular (CV) events. The relationship between sexual activity and incident major adverse cardiovascular events (MACE) in subjects at high CV risk is conflicting and never investigated in ED subjects. The aim of this study was to investigate relationships between frequency of sexual attempts and incident MACE and to retrospectively explore its main determinants in subjects with sexual dysfunction. A consecutive series of 2187 subjects (mean age 49.9 ± 11.6 years old) attending the Outpatient Clinic for sexual dysfunction was retrospectively studied. A subset of the previous sample (N = 1687) was enrolled in a longitudinal study. Frequency of sexual intercourse (coital and non-coital) was assessed using a standard question ('During the last 3 months how many sexual attempts per month did you have?'). In the whole sample, sexual attempts were an age- and testosterone-dependent phenomenon, while no association between frequency of sexual intercourse and ED or premature and delayed ejaculation, was observed. However, when the same analysis was performed according to age tertiles (I = 17-46, II = 47-59, III = 60-88 years old), ED was significantly associated with a higher risk of reduced sexual intercourse in younger (hazard ratio = 1.857 [1.066-3.234]; p = 0.029), but not in middle-aged or older individuals. The marital component, as assessed by SIEDY Scale 2, played a major role in regulating sexual frequency in all age bands. Depressive symptoms represent another independent risk factor for reduced sexual activity (adj r = -0.139; p < 0.0001), in an age-dependent manner. When longitudinal data were analysed, a higher frequency of sexual intercourse significantly reduced the risk of MACE even after adjusting for known CV risk factors for this cohort. Identifying among mild-to-moderate ED subjects those with lower frequency of sexual activity might provide an opportunity to modify their behaviour and to discover subthreshold comorbidities, possibly preventing forthcoming CV events. PMID:24127288

Corona, G; Rastrelli, G; Monami, M; Maseroli, E; Jannini, E A; Balercia, G; Sforza, A; Forti, G; Mannucci, E; Maggi, M

2013-10-11

311

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

PubMed Central

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

2013-01-01

312

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

2013-06-09

313

Isolation and Characterization of Smooth Muscle Cells from Rat Corpus Cavernosum Tissue for the Study of Erectile Dysfunction  

PubMed Central

Purpose Primary culture of the cavernous smooth muscle cells from corpus cavernous tissues is known to be difficult, mainly because of contamination with fibroblasts. We applied a new method for better isolation of rat penile smooth muscle cells (RPSMCs) from rat corpus cavernosum tissue for reliable ex vivo research on erectile dysfunction. Materials and Methods With the use of 8-week-old adult male Sprague-Dawley rats, ex vivo migrations of rat cavernous tissue were measured by penis and aortic ring assay by use of a Matrigel-based D-valine-modified culture method. The expression of ?-smooth muscle actin (?-SMA) and platelet/endothelial cell adhesion molecule (PECAM)-1 in the RPSMCs was determined by standard immunofluorescent staining and immunoblotting. The expression patterns of phosphodiesterase (PDE) family mRNA in RPSMCs were compared with patterns in rat aortic smooth muscle cells (RASMCs) by use of quantitative real-time reverse transcription polymerase chain reaction. Results Immunocytochemical staining showed greater ?-SMA-positive and PCAM-1-negative fluorescence. Moreover, whereas the expression of ?-SMA was detected in the RPSMCs, that of PECAM-1 was not. The levels of PDE1A, PDE1B, PDE1C, PDE2A, PDE3A, PDE4A, PDE4B, PDE4C, PDE4D, and PDE5A mRNA in the RPSMCs were about 3.2-, 4.4-, 3.4-, 29.0-, 3.5-, 2.8-, 2.9-, 6.1-, 45.0-, and 6.0-fold the corresponding expression in RASMCs. Conclusions We developed a two-stage tissue culture method utilizing a Matrigel-based sprouting culture system to facilitate stromal cell sprouting and an adherent culture system using D-valine to eliminate the contamination of fibroblasts into the smooth muscle cells.

Chung, Hong; Jung, Seung-Hyo; Ryu, Ji-Kan; Kim, Bokyung; Kim, Hong Sup

2012-01-01

314

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

PubMed

The purpose of this study was to determine the incidence rate of prostate cancer among men with erectile dysfunction (ED) treated with phosphodiesterase type 5 inhibitors (PDE-5i) over a 7-year period vs. men with ED of the same age and with similar risk factors who were not treated with PDE-5i. In a retrospective review of electronic medical records and billing databases between the years 2000 and 2006, men with ED between the ages of 50 and 69 years and no history of prostate cancer prior to 2000 were identified. These individuals were divided into two groups: 2362 men who had treatment with PDE-5i, and 2612 men who did not have treatment. Demographic data in each group were compared. During the study period, 97 (4.1%) men with ED treated with PDE-5i were diagnosed with prostate cancer compared with 258 (9.9%) men with ED in the non-treated group (P<00001). A higher percentage of African Americans were treated with PDE-5i vs. those who were not (10.5% vs. 7.1%; P<0.0001). The PDE-5i group had lower documented diagnosis of elevated prostate-specific antigen (10.0% vs. 13.1%; P=0.0008) and higher percentage of benign prostatic hyperplasia (38.4% vs. 35.1%; P=0.0149). Men with ED treated with PDE-5i tended to have less chance (adjusted odds ratio: 0.4; 95% confidence intervals: 0.3-0.5; P<0.0001) of having prostate cancer. Our data suggest that men with ED treated with PDE-5i tended to have less of a chance of being diagnosed with prostate cancer. Further research is warranted. PMID:23353723

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

2013-01-28

315

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

PubMed Central

The purpose of this study was to determine the incidence rate of prostate cancer among men with erectile dysfunction (ED) treated with phosphodiesterase type 5 inhibitors (PDE-5i) over a 7-year period vs. men with ED of the same age and with similar risk factors who were not treated with PDE-5i. In a retrospective review of electronic medical records and billing databases between the years 2000 and 2006, men with ED between the ages of 50 and 69 years and no history of prostate cancer prior to 2000 were identified. These individuals were divided into two groups: 2362 men who had treatment with PDE-5i, and 2612 men who did not have treatment. Demographic data in each group were compared. During the study period, 97 (4.1%) men with ED treated with PDE-5i were diagnosed with prostate cancer compared with 258 (9.9%) men with ED in the non-treated group (P<00001). A higher percentage of African Americans were treated with PDE-5i vs. those who were not (10.5% vs. 7.1% P<0.0001). The PDE-5i group had lower documented diagnosis of elevated prostate-specific antigen (10.0% vs. 13.1% P=0.0008) and higher percentage of benign prostatic hyperplasia (38.4% vs. 35.1% P=0.0149). Men with ED treated with PDE-5i tended to have less chance (adjusted odds ratio: 0.4; 95% confidence intervals: 0.3–0.5; P<0.0001) of having prostate cancer. Our data suggest that men with ED treated with PDE-5i tended to have less of a chance of being diagnosed with prostate cancer. Further research is warranted.

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

2013-01-01

316

Erectile dysfunction can improve the effectiveness of the current guidelines for the screening for asymptomatic coronary artery disease in diabetes.  

PubMed

About 40% of diabetic patients with asymptomatic coronary artery disease (CAD) are missed on the basis of the current screening guidelines. Erectile Dysfunction (ED) is a powerful marker of asymptomatic CAD. Aim of the study is to evaluate whether ED can improve the effectiveness of the current guidelines for the screening of CAD in diabetes. From among 299 consecutive men with newly diagnosed type 2 diabetes without any apparent vascular complication, 293 (mean age 56.6±5.9 years) were enrolled. Among them, 219 did not have myocardial ischemia (NO CAD group) and 74 men had a coronary stenosis angiographically proven (CAD group). Five risk factors (RFs) of the current screening guidelines (hypertension, dyslipidemia, family history for CAD, smoking e micro/macroalbuminuria) and ED were assessed. ED was significantly more prevalent in the CAD than in the NO CAD group (37.8 versus 15.1%; P<0.001) and was a predictor of asymptomatic CAD (OR: 4.4; 95%CI: 2.1-9.0; P<0.001). If ED is added to the list of RFs, it can increase the sensitivity of the current guidelines from 62 to 89%, without a significant variation in specificity (from 60 to 57%). The negative predictive value can increase from 82 to 94%. ED can reduce from 37.84 to 10.81% the percentage of patients with silent CAD missed at the screening. This study first shows that ED can improve the effectiveness in discriminating diabetic men to screen for asymptomatic CAD, when it is added to the list of RFs of the current screening guidelines. PMID:21861245

Gazzaruso, Carmine; Coppola, Adriana; Montalcini, Tiziana; Valenti, Cinzia; Garzaniti, Adriana; Pelissero, Gabriele; Salvucci, Fabrizio; Gallotti, Pietro; Pujia, Arturo; Falcone, Colomba; Solerte, Sebastiano B; Giustina, Andrea

2011-08-23

317

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

PubMed Central

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

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

2005-01-01

318

Free radical-scavenging activity of Korean red ginseng for erectile dysfunction in non-insulin-dependent diabetes mellitus rats  

Microsoft Academic Search

ObjectivesTo investigate the antioxidant activity of Korean red ginseng (KRG) and its effect on erectile function in non-insulin-dependent diabetes mellitus (NIDDM) rats. Oxidative stress is an important factor in vascular complications of diabetes.

Ji-Kan Ryu; Tack Lee; Dae-Joong Kim; In-Sun Park; Sang-Min Yoon; Hong-Sik Lee; Sun U. Song; Jun-Kyu Suh

2005-01-01

319

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

PubMed

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

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

2011-09-15

320

[Erectile disorders: the reality].  

PubMed

The grouping together of erectile dysfunction and erectile disorder (i.e. dysfunction with distress) has led to the presentation of incredibly high prevalences (up to 52%). When limited to erectile disorder, two Dutch open population studies, among men aged 40-79 years, show remarkably similar and more realistic prevalences, namely 3 to 10%. Although the 'Leiden Impotence Screening Test' appears to reliably exclude somatic aetiological factors, it would be preferable if the general physician posed such diagnostic questions. It is hoped that the availability of pharmacotherapeutic treatments (notably sildenafil) will not tempt the general physician to join the patient in his inclination to 'somatise' his erectile disorder. Both intracavernosal self-injection therapy and the implantation of an erectile prosthesis give rise to a large proportion of dissatisfied men. In the Netherlands to date, the number of continuation prescriptions for sildenafil equals the number of first prescriptions, which suggests that many men also stop with this therapy. In the Netherlands, health insurance companies only reimburse self-injections and prosthesis implantations. It can be argued that all cost-effective treatments for erectile disorder, including psychosexual therapy, should be reimbursed, or none at all. PMID:11494685

Hengeveld, M W; Gianotten, W L

2001-07-21

321

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

PubMed Central

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

2012-01-01

322

A randomized, double-blind, crossover, placebo-controlled comparative clinical trial of arginine aspartate plus adenosine monophosphate for the intermittent treatment of male erectile dysfunction.  

PubMed

Efficacy and safety of l-arginine aspartate 8 g combined with 200 mg of adenosine monophosphate (AA) with placebo (PL) alone for intermittent treatment of mild-to-moderate erectile dysfunction (ED) were compared. The study design was a double-blind, PL-controlled, two-way crossover randomized clinical trial with 26 patients. Efficacy was assessed by International Index of Erectile Function (IIEF) and two additional validated questionnaires [the Erection Hardness Score (EHS) and the Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS). During each crossover period, separated by a 2-week wash-out period, drugs were administered orally, 1-2 h before sexual intercourse. Primary endpoint was a change in the IIEF. Secondary endpoints were patient and investigator assessments of treatment success. Investigators' and patients' assessment of efficacy was significantly improved by the combination vs. PL (p = 0.01 and p = 0.04 respectively]. EHS and EDITS questionnaires were both improved by the combination (p = 0.015 and p = 0.017 respectively). There was no significant difference in terms of tolerance between AA and PL or severe adverse events. ED patients demonstrated significant improvements in all IIEF domains with the exception of the Sexual Desire and Orgasmic Domains when treated with AA compared with PL. This pilot phase II study showed that the on-demand oral administration at a high dosage of l-arginine aspartate-adenosine monophosphate combination may be effective in patients with mild-to-moderate ED, is very well tolerated and could be tested as a safe first-line therapy in a larger size phase III study. PMID:23413135

Neuzillet, Y; Hupertan, V; Cour, F; Botto, H; Lebret, T

2012-12-26

323

Effects of Korean ginseng berry extract on sexual function in men with erectile dysfunction: a multicenter, placebo-controlled, double-blind clinical study.  

PubMed

Ginseng is beneficial for many aspects of human physiology, including sexual function. In this study, we have evaluated the efficacy and safety of an extract of ginseng berry, which has a ginsenoside profile distinct from other parts of the plant, on sexual function in men with erectile dysfunction. In all, 119 men with mild-to-moderate ED participated in a multicenter, randomized, double-blind, parallel, placebo-controlled clinical study. They were administered 4 tablets of either standardized Korean ginseng berry (SKGB, 350 mg ginseng berry extract per tablet), or placebo, daily, for 8 weeks. Efficacy was assessed with the International Index of Erectile Function (IIEF)-15 and premature ejaculation diagnostic tool (PEDT) at the end of the 4th and 8th week. We observed that the total and each of the individual domain scores of IIEF-15 increased from 40.95 ± 7.05 to 46.19 ± 12.69 significantly in the SKGB by the 8th week (P<0.05). The erectile function domain of IIEF changed slightly from 17.17 ± 2.57 to 18.59 ± 5.99 in the SKGB group by the 8th week (P<0.05). In addition, PEDT scores significantly improved from 9.14 ± 4.57 to 7.97 ± 4.4 and 7.53 ± 4.26 in the SKGB group after 4 and 8 weeks of treatment (P<0.05). Safety markers including hormone and lipid in the blood were assessed at the end of the 4th and 8th week and they remained unchanged. Oral administration of the SKGB extract improved all domains of sexual function. It can be used as an alternative medicine to improve sexual life in men with sexual dysfunction. PMID:23254461

Choi, Y D; Park, C W; Jang, J; Kim, S H; Jeon, H Y; Kim, W G; Lee, S J; Chung, W S

2012-12-20

324

Comparative value of prostaglandin E1 and papaverine in treatment of erectile failure: double-blind crossover study among Egyptian patients.  

PubMed

In a double-blind, crossover designation penile intracavernous prostaglandin E1 and papaverine hydrochloride were compared in regard to effectiveness and safety in 52 patients investigated and treated for sexual erectile dysfunction. In evidence of the reliable effectiveness, prostaglandin E1 (20 micrograms/ml.) induced significant positive erectile response in 42 of 52 patients (81%). This rate reached 100% with neurogenic, hyperprolactinemic and/or psychogenic impotence. However, with papaverine hydrochloride (30 mg./ml.) and exclusively in cases of vasculogenic (most probably arteriogenic) impotence, negative erectile response was revealed as absent erection in 6 of 52 patients (11.5%) and nonrigid tumescence in 13 (25%) versus 2 (3.8%) and 8 (15.4%), respectively, with prostaglandin E1. Moreover, with prostaglandin E1 the regional pain was tolerable and transient, and the positive erectile response was not attended by priapism even in patients who formerly had priapism with papaverine hydrochloride. However, presently with prostaglandin E1 the relatively higher cost and shorter expiration period would probably limit its diagnostic and therapeutic use in Egypt, and probably in other developing countries. PMID:1538443

Mahmoud, K Z; el Dakhli, M R; Fahmi, I M; Abdel-Aziz, A B

1992-03-01

325

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

PubMed Central

INTRODUCTION Hypercholesterolemia induces erectile dysfunction (ED) mostly by increasing oxidative stress and impairing endothelial function in the penis, but the mechanisms regulating reactive oxygen species (ROS) production in the penis are not understood. AIMS We evaluated whether hypercholesterolemia activates nicotinamide adenine dinucleotide phosphate (NAD[P]H) oxidase in the penis, providing an initial source of ROS to induce endothelial nitric oxide synthase (eNOS) uncoupling and endothelial dysfunction resulting in ED. METHODS Low-density-lipoprotein receptor (LDLR)–null mice were fed Western diet for 4 weeks to induce early-stage hyperlipidemia. Wild type (WT) mice fed regular chow served as controls. Mice received NAD(P)H oxidase inhibitor apocynin (10 mM in drinking water) or vehicle. Erectile function was assessed in response to cavernous nerve electrical stimulation. Markers of endothelial function (phospho [P]-vasodilator-stimulated-protein [VASP]-Ser-239), oxidative stress (4-hydroxy-2-nonenal [HNE]), sources of ROS (eNOS uncoupling and NAD[P]H oxidase subunits p67phox, p47phox, and gp91phox), P-eNOS-Ser-1177, and eNOS were measured by Western blot in penes. MAIN OUTCOME MEASURES Molecular mechanisms of ROS generation and endothelial dysfunction in hypercholesterolemia-induced ED. RESULTS Erectile response was significantly (P<0.05) reduced in hypercholesterolemic LDLR-null mice compared to WT mice. Relative to WT mice, hypercholesterolemia increased (P<0.05) protein expressions of NAD(P)H oxidase subunits p67phox, p47phox and gp91phox, eNOS uncoupling, and 4-HNE-modified proteins, and reduced (P<0.05) P-VASP-Ser-239 expression in the penis. Apocynin treatment of LDLR-null mice preserved (P<0.05) maximal intracavernosal pressure, and reversed (P < 0.05) the abnormalities in protein expressions of gp67phox and gp47phox, 4-HNE, P-VASP-Ser-239, and eNOS uncoupling in the penis. Apocynin treatment of WT mice did not affect any of these parameters. Protein expressions of P-eNOS-Ser-1177 and total eNOS were unaffected by hypercholesterolemia. CONCLUSION Activated NAD(P)H oxidase in the penis is an initial source of oxidative stress resulting in eNOS uncoupling, thus providing a mechanism of eNOS uncoupling and endothelial dysfunction in hypercholesterolemia-induced ED.

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

2010-01-01

326

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

PubMed

Satisfaction with the sexual experience is considered important when evaluating the impact of treatments for erectile dysfunction, yet enhanced satisfaction has been infrequently assessed in the sexual trials. We evaluated the efficacy of sildenafil vs. tadalafil, in Saudi men with erectile dysfunction and determined the self-based rating of medicinal preference. Sildenafil citrate (Viagra) is a potent inhibitor of the electrolytic enzyme type V phosphodiesterase (PDE5), in the corpus cavernosum and therefore increases the penile response to sexual stimulation. Tadalafil (Cialis) is also a PDE5 inhibitor that increases the level of cyclic guanosine monophosphate (cGMP) in cavernous smooth muscle cells. Whereas cGMP is a second messenger for the vasodilator effects of nitric oxide causing smooth muscle relaxation, which in turn leads to penile erection; however the mechanism by which cGMP stimulates relaxation of the smooth muscles remains to be elucidated. Both sildenafil and tadalafil have a rapid onset with the effectiveness up to 4 hours and 36 hours respectively. In this study subjects treated with 100 mg oral dose of sildenafil / 20 mg tadalafil were found to be associated with higher mean scores for the questions of the International Index of Erectile Function (IIEF). Frequency of penetration and maintenance of erection after sexual penetration and/or during masturbation were found to be enhanced significantly (p<0.001) in both sildenafil/tadalafil treated men. Similarly mean domain of erectile function, orgasmic function, and intercourse satisfaction also showed a significantly positive improvement (p/0.001) in both the treated groups in comparison with their age matched untreated controls. Interestingly in all the cases, tadalafil group showed considerably greater positive responses than the sildenafil group but within the same significant levels. Strikingly the sexual-desire domain in sildenafil treated men with respect to their aged matched controls showed a non-significant difference, where as this difference was found to be highly significant in tadalafil treated group. Similarly mean scores for the overall satisfaction domains of the IIEF in comparison with the untreated subjects showed a significant positive response in the sildenafil treated group (p<0.001), where as tadalafil treated group showed a highly significant positive response (p<0.005). These findings suggest that both sildenafil and tadalafil may assist an individual in extending/enhancing the excitement phase or prolonging the sexual interaction. These studies further conclude that there is a major point of difference between the short-acting agent sildenafil and the longer acting tadalafil. This probably allows more choice about the onset of sexual responses with tadalafil than with sildenafil. PMID:18614424

Ali, Syed Tabrez

2008-07-01

327

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

328

Pharmacological Prevention and Reversion of Erectile Dysfunction After Radical Prostatectomy, by Modulation of Nitric Oxide/cGMP Pathways.  

National Technical Information Service (NTIS)

During years 1 and 2 we have shown that long-term sustained administration of high doses of PDE5 inhibitors (tadalafil and sildenafil, previously vardenafil), prevented in a rat model of cavernosal nerve damage post-radical prostatectomy the erectile dysf...

N. F. Gonzalez-Cadavid

2010-01-01

329

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.

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

2013-01-01

330

[Intraurethrally applicated alprostadil for the treatment of organic erectile dysfunction in practice: a multicenter clinical monitoring study (noninterventional investigation)].  

PubMed

In a multicenter clinical monitoring study (observation of use investigation according to 67.6 of the German Drug Law), which was conducted between 2003 and 2005 in 105 urological practices in 314 patients with organic erectile dysfunction (ED), efficacy, safety, convenience and acceptance of intraurethral administered alprostadil (CAS 745-65-3; MUSE - Medicated Urethral System for Erection) was studied. 306 patients could statistically be evaluated. The patients were 61.3 +/- 9.2 years old (median+/- SD) (181 patients between 60 and 80 y). The time of ED was from 2 to 120 months with a mean duration of 21.5 +/- 22 months (median+/-SD. Genesis of the ED was in 55 % of the patients a local damage, which followed in 42.8 % a prostate cancer surgery. 46 % of the patients had vascular, 28 % metabolic diseases including diabetes and 11% neural damages. In 51.3% of the patients drugs, which were known to induce ED, were suspected to have caused or partially caused the impairment. The degree of the disturbance was in 93 % of the cases moderate to severe. Alprostadil (MUSE) was applicated three times in doses of 250, 500 or 1000 microg. The dosage of 1000 microg was used for the third application by 65 % of the patients. Very good and good efficacy increased from 45.8% of the patients after the first through 63.7 % after the second to 69.3 % after the third application. In patients after surgery because of prostate cancer very good and good efficacy improved in comparison to the first application about 20% and concerned 53.9 % of the patients after the third application. Sexual intercourse was possible by 67% of the patients after the first, 83 % after the second and 87 % after the third use. Tolerability of alprostadil (MUSE) was very good and good in 90% of the patients. 81.1% intended to continue the treatment. The handling of alprostadil (MUSE) was assessed very good and good by 75%, the acceptance was very good and good in 96% of the patients. In a retrospective comparison with other drugs for the treatment of ED intracavernosal alprostadil ("SKAT") was slightly more effective than intraurethral alprostadil (MUSE) (32.1% vs 25 %), but alprostadil (MUSE) was assessed more useful by 82.1% and preferred by 78.6% of the patients. In comparison to phosphodiesterase-5- (PDE-5)-inhibitors alprostadil (MUSE) was more effective in 77.7 %, and 79.6 % of the patients preferred it. In comparison to apomorphin 94.1% preferred alprostadil (MUSE). 98 % of the patients reported better efficacy of alprostadil (MUSE), and 94.1% preferred it. Five adverse events were reported (slight urethral pain). No patient dropped out. In this non-interventional investigation the good efficacy and tolerability of intraurethral applicated alprostadil (MUSE) as a second-line therapy after failure or minor efficacy of PDE-5 inhibitors and other oral drugs was comparable with the results of the clinical trials. The patients in the urological practices assessed handling and acceptance of the system high. PMID:17688074

Potempal, Axel-Jürg; Potempa, Dirk M; Görlich, Hans Diether; Stolpmann, Rainer M

2007-01-01

331

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

PubMed

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

Senbel, Amira M; Helmy, Mai M

2013-08-25

332

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

PubMed

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

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

2013-01-24

333

Vasculogenic impotence and cavernosal oxygen tension  

Microsoft Academic Search

Aims of this study: To determine the associations, if any, of cavernosal oxygen tension with vasculogenic impotence.Materials and Methods: We evaluated penile cavernosal blood gas levels in men with suspected vasculogenic impotence during penile duplex ultrasonography and\\/or dynamic infusion cavernosometry and cavernosography (DICC). Patients with suspected impotence were evaluated from 1992–1996. Patient ages ranged from 24–75 y (mean 48 y).

SL Brown; AD Seftel; KP Strohl; TE Herbener

2000-01-01

334

The triad of erectile dysfunction, testosterone deficiency syndrome and metabolic syndrome: findings from a multi-ethnic Asian men study (The Subang Men's Health Study).  

PubMed

The etiology of erectile dysfunction (ED) is multi-factorial. This paper examines the association between ED, testosterone deficiency syndrome (TDS) and metabolic syndrome (MS) in Malaysian men in an urban setting. One thousand and forty-six men aged ? 40 years from Subang Jaya, Malaysia were randomly selected from an electoral-roll list. The men completed questionnaires that included: socio-demographic data, self-reported medical problems and the International Index of erectile function (IIEF-5). Physical examination and the following biochemical tests were performed: lipid profile, fasting blood glucose (FBG) and total testosterone. The response rate was 62.8% and the mean age of men was 55.8 ± 8.4 (41-93) years. Ethnic distribution was Chinese, 48.9%; Malay, 34.5%; Indian, 14.8%. The prevalence of moderate-severe ED was 20.0%, while 16.1% of men had TDS (< 10.4 nmol/L) and 31.3% of men had MS. Indian and Malay men were significantly more likely to have ED (p ?= 0.001), TDS (p ?< 0.001) and MS (p < 0.001) than the Chinese. Multivariate regression analysis showed that elevated blood pressure, elevated FBG, low high-density lipoprotein and heart disease were predictors of ED while all MS components were independently associated with TDS. Malay and Indian men have a higher disease burden compared to Chinese men and were more likely to suffer with ED, TDS and MS. MS components were closely related to TDS and ED. PMID:22115177

Tan, Wei Shen; Ng, Chirk Jenn; Khoo, Ee-Ming; Low, Wah-Yun; Tan, Hui Meng

2011-12-01

335

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

PubMed

Aim: We evaluated the effectiveness of tamsulosin monotherapy versus tamsulosin plus sildenafil combination therapy on erectile dysfunction (ED) in young patients with type III chronic prostatitis and ED by using symptom score scales. Materials and methods: 44 male patients were divided into 2 groups: the first group (20 patients) was treated with tamsulosin 0,4 mg monotherapy and the second one 24 patients) was treated with tamsulosin 0,4 mg plus sildenafil 50 mg combination therapy. “International Prostate Symptom Score” (IPSS), “National Institute of Health Chronic Prostatitis Symptom Index” (NIH-CPSI) and “International Index of Erectile Function” (IIEF-5) were inves- tigated in each group of patients, and scores calculated during the first medical examination. Both groups were treated with tamsulosin once daily for 60 days, while sildenafil 50 mg was given on demand (at least 2 times per week) for 60 days. During the second medical examination IPSS, NIH-CPSI and IIEF-5 scores were analyzed once more. Afterwards, the alterations of scores among medical examinations in each group and between both groups were statistically compared. Results: The age average of the 44 cases included was 32.04 ± 3.15 years. Both groups present a statistically significant decrease, between the first and the second medical examination, in IPSS, NIH-CPSI scores and statistically significant increase in IIEF-5 score. In addition, there is no sta- tistically significant difference, in all scores, between mono and combination therapy. Conclusions: tamsulosin monotherapy, as well as a combination therapy (tamsulosin plus silde-nafil) has an improving effect on symptoms and on ED in patients with type III prostatitis. In the near future alpha-blockers monotherapy could be used in the treatment of chronic prostatitis and ED cases instead of phosphodiesterase type 5 (PDE-5) inhibitors combination therapy. PMID:24085230

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

2013-09-26

336

Efficacy and satisfaction rates of oral PDE5is in the treatment of erectile dysfunction secondary to spinal cord injury: A review of literature  

PubMed Central

Concept Decreased sexual function is a major concern of men with spinal cord injuries (SCIs). Treatment of erectile dysfunction (ED) through oral pharmacotherapies has been proven to be an effective way to address and treat this concern. Objective To find an efficacious and satisfactory treatment ED secondary to SCI through the compilation of studies that utilized the International Index of Erectile Function (IIEF) when testing phosphodiesterase V inhibitors (PDE5i). Method Ten articles, which used the IIEF to study satisfaction and/or efficacy of PDE5is sildenafil, tadalafil, and vardenafil in the treatment of ED were reviewed and analyzed. Through the use of a self-made grading scale the value of each article was determined for this research. Results Sildenafil, tadalafil, and vardenafil all have been proven to be effective in treating ED in men with SCI. While sildenafil is the most thoroughly studied ED treatment for patients with SCI, tadalafil has a longer time duration effectiveness, which allows for more spontaneity in the sexual experience. Minimal adverse effects have been noted in patients with SCI using these medications; headache, flushing, and mild hypotension are the most common. In articles that study satisfaction, patients show great improvement over baseline with the use of these medications. Conclusion Although there is a need for further research on the safety in long-term use of tadalafil and vardenafil, comparative studies done on all three medications show no statistically significant difference in effectiveness or satisfaction. New medications and treatment options, such as avanafil, are being studied in hope of continued improvement of sexual function in men with SCI.

Rizio, Nicole; Tran, Claire; Sorenson, Matthew

2012-01-01

337

A double-blind, randomised- placebo, controlled, parallel group, multicentre, flexible-dose escalation study to assess the efficacy and safety of sildenafil administered as required to male outpatients with erectile dysfunction in Korea  

Microsoft Academic Search

The efficacy and safety of sildenafil was evaluated in a randomiSed, double-blind, placebo-controlled, flexible-dose study in Korean men aged 28–78 y with erectile dysfunction (ED) of broad-spectrum aetiology and more than 6 months duration. A total of 133 patients were randomised at six centres in Korea to receive either sildenafil (50 mg initially, increased if necessary to l00 mg or

H K Choi; T Y Ahn; J J Kim; S C Kim; J S Paick; J K Suh; H S Kim; Y K Kim; W H Lee; B H Oh; C H Park; W S Ryu; T G Chung; S W Kim; D G Moon; D S Ryu; K K Seo; D K Kim; D S Lee

2003-01-01

338

ASSESS3: A randomised, double-blind, flexible-dose clinical trial of the efficacy and safety of oral sildenafil in the treatment of men with erectile dysfunction in Taiwan  

Microsoft Academic Search

The efficacy and safety of sildenafil were evaluated in a randomised, double-blind, placebo-controlled, flexible-dose study in Taiwanese men aged 26 to 80 y with erectile dysfunction (ED) of broad-spectrum aetiology and more than 6 months' duration. A total of 236 patients were randomised at six medical centres in Taiwan to receive either sildenafil (50 mg initially increased if necessary to

K-K Chen; JT Hsieh; ST Huang; DB-P Jiaan; JS-N Lin; CJ Wang

2001-01-01

339

Evaluation of the Efficacy and Safety of Once-a-Day Dosing of Tadalafil 5 mg and 10 mg in the Treatment of Erectile Dysfunction: Results of a Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial  

Microsoft Academic Search

Background: Erectile dysfunction (ED) is a chronic disease; however, therapy is currently administered as needed with oral phosphodiesterase 5 (PDE5) inhibitors like tadalafil. Because the 17.5-h half-life of tadalafil enables therapeutic plasma levels to be sustained with daily administration, tadalafil is a good candidate for once daily dosing therapy. Methods: This multicenter, randomized, double-blind, placebo-controlled, parallel- group, 12-week study enrolled

Hartmut Porst; Francois Giuliano; Sidney Glina; David Ralph; Adolfo R. Casabee; Albert Elion-Mboussa; Wei Shen; J. Steve Whitaker

340

The efficacy and safety of a topical alprostadil cream, Alprox-TD®, for the treatment of erectile dysfunction: two phase 2 studies in mild-to-moderate and severe ED  

Microsoft Academic Search

In two multicenter, placebo controlled, phase 2 studies, patients with mild-to-moderate (n=161, Study 1) or severe (n=142, Study 2) erectile dysfunction (ED) were randomized to receive placebo, 0.05, 0.1, or 0.2 mg (Study 1) or placebo, 0.1, 0.2, or 0.3 mg (Study 2) of topically applied alprostadil (containing a proprietary skin permeation enhancer). The primary efficacy end point in both

H Padma-Nathan; C Steidle; S Salem; N Tayse; J Yeager; R Harning

2003-01-01

341

Erectile dysfunction after radiotherapy for prostate cancer: a model assesing the conflicting literature on dose-volume effects.  

PubMed

Studies assessing the relationship between dose to the penile bulb (PB) and risk of ED in men treated for prostate cancer with external beam radiation therapy (EBRT) have been critically scored. A review of published literature examining dose received by the PB and clinical erectile function outcomes for patients receiving EBRT was performed. Of 146 retrieved articles, 8 evaluated EBRT-induced ED in relation to PB dose. Half of these articles showed a relationship between dose to PB and ED, and the other half did not. A reliability score (RS) was constructed to more uniformly evaluate strengths and weaknesses of these eight articles. Subsequently, they were scored by two independent reviewers. An average of both scores was calculated. A close consensus was found (identical RS for six of the eight studies; kappa statistic: P=0.97). The studies with highest RS consistently support a relationship between ED and PB doses, whereas those with low scores did not. The RS-based analysis supports the recommended dose-volume limits specified in the Quantitative Analysis of Normal Tissue Effects in the Clinic review, maintaining the mean dose to 95% of the PB <50?Gy, although the target organ at risk is not likely to be the PB. PMID:23784555

Rivin Del Campo, E; Thomas, K; Weinberg, V; Roach, M

2013-06-20

342

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.

Moyad, Mark A; Park, Kwangsung

2012-01-01

343

The relationship of serum and salivary cortisol levels to male sexual dysfunction as measured by the International Index of Erectile Function  

PubMed Central

To evaluate the biomarkers of sexual function, we investigated the relationship between questionnaire responses and biological hormones such as testosterone (T) and cortisol (F) in serum and saliva. The study population included 105 men aged 30–72 years (mean: 49±4.5, median: 49). Levels of all serum hormones (Total-T, Free-T, Bioavailable-T, Total-F and Bioavailable-F) and salivary hormones (Saliva-T and Saliva-F) were measured directly by liquid chromatography/tandem mass spectrometry. The International Index of Erectile Function (IIEF) was used as a questionnaire to evaluate sexual dysfunction. Free-T and Bioavailable-T showed significant inverse correlations with age (P<0.01). In the group not taking antidepressants, the levels of Bioavailable-F and Saliva-F showed significant inverse correlations with a portion of the IIEF score (P<0.05). However, reductions in Bioavailable-T and Saliva-T showed no association with the IIEF score. In the group taking antidepressants, these hormone levels showed no correlation with IIEF.

Kobori, Y; Koh, E; Sugimoto, K; Izumi, K; Narimoto, K; Maeda, Y; Konaka, H; Mizokami, A; Matsushita, T; Iwamoto, T; Namiki, M

2009-01-01

344

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

PubMed

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

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

2013-02-01

345

Long-term efficacy and safety of self-intracavernous injection of prostaglandin E1 for treatment of erectile dysfunction in China.  

PubMed

The study evaluated the long-term efficacy and safety profiles of self-intracavernous injection of prostaglandin E1 (PGE1) for erectile dysfunction (ED). Four hundred and sixteen ED patients were treated with self-intracavernous injection of PGE1 from January 1998 to December 2007 in our outpatient service. Follow-up was made to investigate the efficacy and side effects of this treatment. It was found that 261 patients (62.7%) felt satisfied and kept using this treatment due to its advantages of satisfactory efficacy and reasonable expense. Twenty-seven of them (6.5%) got rid of PGE1 treatment after five times injections and did not need any other drugs to maintain satisfactory sexual lives. Two hundred and fourteen (51.4%) patients kept using this treatment for over 1 year, 26 (6.2%) over 5 years, 12 (2.9%) over 8 years and 7 (1.7%) over 10 years. The major complications of self-intracavernous injection of PGE1 include fibrosis of corpus cavernosum (three cases), ecchymosis associated with vascular injury due to injection (23 cases) and pain associated with injection (295 cases). There were no patients displaying priapism. It is concluded that self-intracavernous injection of PGE1 is a safe and effective treatment for ED with various aetiologies and a broad range of severity, and no serious complications were observed after long-term application. PMID:21486416

He, L; Wen, J; Jiang, X; Chen, H; Tang, Y

2011-03-25

346

Radioisotope penogram in diagnosis of vasculogenic impotence.  

PubMed

A radioisotope technique to estimate penile blood flow is described. The radioisotope penogram is noninvasive and gives a dynamic evaluation of the arterial supply, venous drainage, and blood flow in the corporeal bodies. The penogram is a valuable adjunct in evaluation of patients with vasculogenic impotence. PMID:6293142

Fanous, H N; Jevtich, M J; Chen, D C; Edson, M

1982-11-01

347

Assessment of the efficacy of combination therapy with folic acid and tadalafil for the management of erectile dysfunction in men with type 2 diabetes mellitus.  

PubMed

INTRODUCTION.: Phosphodiesterase type 5 inhibitors PDE5Is are less effective in diabetic men with erectile dysfunction (ED); however, the effect of combination therapy with folic acid and PDE5Is in these patients has not been investigated. AIM.: To evaluate the efficacy and safety of combination therapy with folic acid and tadalafil for the management of ED in men with type 2 diabetes mellitus. METHODS.: Eighty-three patients with type 2 diabetes mellitus and ED were included in this randomized double-blind clinical trial. They were randomly divided into two groups. Group A was treated with tadalafil 10?mg every other day plus folic acid 5?mg daily and group B received tadalafil 10?mg every other day plus placebo daily for 3 months. The mean International Index of Erectile Function (IIEF) scores before and after treatment in each groups were recorded. Men with diagnosis of psychological ED, spinal cord injury, or who used folic acid in the past 3 months and patients with any contradiction for use of PDE5Is were excluded. MAIN OUTCOMES MEASURES.: The cross tabulation and independent t-test were used to evaluate the difference between baseline characteristic of the patients in the two groups. Wilcoxon signed-ranks test and Mann-Whitney U-test were used to evaluate the IIEF score and also its changes before and after treatment in the two groups. RESULTS.: The mean IIEF scores before and after treatment were 11.65?±?2.67 and 16.80?±?4.03 in group A (P?

Hamidi Madani, Ali; Asadolahzade, Ahmad; Mokhtari, Gholamreza; Shahrokhi Damavand, Reza; Farzan, Alireza; Esmaeili, Samaneh

2013-01-24

348

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

SciTech Connect

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

Kerns, Sarah L.; Ostrer, Harry [Department of Pediatrics, New York University School of Medicine, New York, NY (United States); Stock, Richard [Department of Radiation Oncology, Mount Sinai School of Medicine, New York, NY (United States); Li, William [Department of Radiation Oncology, Queens/Elmhurst Hospital Center, Jamaica, NY (Jamaica); Moore, Julian [Department of Radiation Oncology, Mount Sinai School of Medicine, New York, NY (United States); Pearlman, Alexander; Campbell, Christopher [Department of Pediatrics, New York University School of Medicine, New York, NY (United States); Shao Yongzhao [Division of Biostatistics, New York University School of Medicine, New York, NY (United States); Stone, Nelson [Department of Radiation Oncology, Mount Sinai School of Medicine, New York, NY (United States); Department of Urology, Mount Sinai School of Medicine, New York, NY (United States); Kusnetz, Lynda [Department of Radiation Oncology, Mount Sinai School of Medicine, New York, NY (United States); Rosenstein, Barry S., E-mail: barry.rosenstein@mssm.ed [Department of Radiation Oncology, Mount Sinai School of Medicine, New York, NY (United States); Department of Radiation Oncology, New York University School of Medicine, New York, NY (United States)

2010-12-01

349

The combination of penoscrotal rings and PDE5i's in the treatment of erectile dysfunction – the Sheffield PDE5i and ring duo technique. Two case reports  

Microsoft Academic Search

Venoocclusive disorder, also known as venous leak and anticipatory anxiety, are both common causes of erectile disorder. The clinical presentation and investigations using ultrasonography have some common findings during the preliminary assessment process. We present a treatment approach which may be offered in both conditions and which may require reduced doses or eventually allow withdrawal off medication. The Sheffield PDE5i

Kevan R. Wylie; Ruth A. Hallam-Jones; David Steward

2006-01-01

350

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  

Microsoft Academic Search

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,

P Gontero; S SRIPRASAD; C J WILKINS; N DONALDSON; G H MUIR

2004-01-01

351

Slug promoted vasculogenic mimicry in hepatocellular carcinoma  

PubMed Central

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

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

2013-01-01

352

Slug promoted vasculogenic mimicry in hepatocellular carcinoma.  

PubMed

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

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

2013-07-01

353

Penile xenon (/sup 133/Xe) washout: a rapid method of screening for vasculogenic impotence  

SciTech Connect

The radioactive inert gas xenon (/sup 133/Xe) is a well-established isotopic indicator used to assess vascular status in many organ systems. Xenon-133 was used to evaluate male impotence. Xenon-133 was injected subcutaneously at the level of the coronal sulcus in the detumescent state. Using the gamma camera, sequential images were obtained and computer-generated curves calculated. The clearance time for 50 per cent washout of the injected /sup 133/Xe (T1/2) was then calculated for each patient, as well as a control group. Preliminary findings indicate a correlation with such established techniques of evaluating erectile impotence as history, physical examination, penile pulse Doppler tracings, and brachial-penile blood pressure index. The xenon-133 washout study was a rapid, minimally invasive, reproducible, and cost-effective method of screening those impotent patients for vasculogenic etiology of their erectile impotence. We recommend the addition of this method to the surgeon engaged in the care of impotent males.

Nseyo, U.O.; Wilbur, H.J.; Kang, S.A.; Flesh, L.; Bennett, A.H.

1984-01-01

354

Effect of icarisid II on diabetic rats with erectile dysfunction and its potential mechanism via assessment of AGEs, autophagy, mTOR and the NO-cGMP pathway  

PubMed Central

Erectile dysfunction (ED) is a major complication of diabetes mellitus. Icariin has been shown to enhance erectile function through its bioactive form, icarisid II. This study investigates the effects of icarisid II on diabetic rats with ED and its potential mechanism via the assessment of advanced glycosylation end products (AGEs), autophagy, mTOR and the NO–cGMP pathway. Icarisid II was extracted from icariin by an enzymatic method. In the control and diabetic ED groups, rats were administered normal saline; in the icarisid II group, rats were administered icarisid II intragastrically. Erectile function was evaluated by measuring intracavernosal pressure/mean arterial pressure (ICP/MAP). AGE concentrations, nitric oxide synthase (NOS) activity and cGMP concentration were assessed by enzyme immunoassay. Cell proliferation was analysed using methyl thiazolyl tetrazolium assay and flow cytometry. Autophagosomes were observed by transmission electron microscopy, monodansylcadaverine staining and GFP-LC3 localisation. The expression of NOS isoforms and key proteins in autophagy were examined by western blot. Our results have shown that Icarisid II increased ICP/MAP values, the smooth muscle cell (SMC) growth curve, S phase and SMC/collagen fibril (SMC/CF) proportions and decreased Beclin 1 (P<0.05). Icarisid II significantly increased the proliferative index and p-p70S6K(Thr389) levels and decreased the numbers of autophagosomes and the levels of LC3-II (P<0.01). Icarisid II decreased AGE concentrations and increased cGMP concentration, NOS activity (P<0.05) and cNOS levels (P<0.01) in the diabetic ED group. Therefore, Icarisid II constitutes a promising compound for diabetic ED and might be involved in the upregulation of SMC proliferation and the NO–cGMP pathway and the downregulation of AGEs, autophagy and the mTOR pathway.

Zhang, Jian; Li, Ai-Min; Liu, Bao-Xing; Han, Fei; Liu, Feng; Sun, Shao-Peng; Li, Xin; Cui, Shu-Jin; Xian, Shao-Zhong; Kong, Guang-Qi; Xin, Zhong-Cheng; Ji, Zhi-Li

2013-01-01

355

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

2010-06-03

356

Intracavernous Alprostadil Alfadex—an effective and well tolerated treatment for erectile dysfunction. Results of a long-term European study  

Microsoft Academic Search

Long-term efficacy and safety of Alprostadil-Alfadex (EDEXR\\/VIRIDALR) in intracavernous self-injection therapy for chronical erectile failure was investigated in a four year running multicenter European trial. Of the 16 886 protocolled injections 93% (15 713) resulted in rigid erections followed by successful sexual intercourse. Reported side effects by patients were prolonged erections >6 h only occurring during the first year in

H Porst; J Buvat; E Meuleman; V Michal; G Wagner

1998-01-01

357

Predictors of erectile function improvement in obstructive sleep apnea patients with long-term CPAP treatment  

Microsoft Academic Search

The long-term effect of treatment with continuous positive airway pressure (CPAP) on erectile function was assessed in 60 patients with obstructive sleep apnea syndrome (OSAS). Severity of OSAS was evaluated by respiratory disturbance index (RDI) and minimal oxygen saturation (OxiMin). Severity of erectile dysfunction (ED) was assessed with the five question International Index of Erectile Function (IIEF-5) before and after

D Margel; R Tal; P M Livne; G Pillar

2005-01-01

358

Radiation thresholds and rehabilitative therapy with erectile preservation after radiotherapy for prostate cancer  

Microsoft Academic Search

Critical targets for radiation-induced erectile dysfunction have been proposed, with most studies supporting the proximal\\u000a penis as an important site-specific structure. Pre-implant erectile function and dose to the proximal penis are the strongest\\u000a predictors of post-treatment erectile function. Refinements in technique that minimize radiation dose to normal surrounding\\u000a structures, especially the proximal penis, should result in improved rates of potency

Gregory S. Merrick; Wayne M. Butler; Kent E. Wallner

2007-01-01

359

Neurological risk profile in organic erectile impotence.  

PubMed Central

Thirty men who presented with erectile impotence to the urological department underwent a thorough urological, angiological, and neurological examination with complementary neurophysiological tests of somatosensory and sympathetic and parasympathetic function. Most had vascular and neurological abnormalities. Clinical findings and electrophysiological tests for autonomic dysfunction had the highest yield of abnormal results. Nerve conduction studies and pudendal nerve somatosensory evoked potentials were far less informative. The lack of correlation between vascular and general neurological abnormalities emphasises that patients must be screened for both vascular and neurological dysfunction to prevent unrewarding vascular operation in impotent men.

Kunesch, E; Reiners, K; Muller-Mattheis, V; Strohmeyer, T; Ackermann, R; Freund, H J

1992-01-01

360

Study on vasculogenic mimicry in malignant esophageal stromal tumors  

Microsoft Academic Search

AIM: To investigate whether malignant esophageal stromal tumors contain PAS-positive patterned matrix-associated vascular channels, which are lined by tumor cells, but not vascular endothelial cells. That is vasculogenic mimicry (VM) independent of tumor angiogenesis. METHODS: Thirty-six tissue samples of malignant esophageal stromal tumors were analyzed. Tissue sections were stained for Vascular endothelial growth factor (VEGF), CD31 and periodic acid Schiff

Hui Zhao; Xiao-Meng Gu; Satoshi Osawa

2008-01-01

361

ERECTILE RESPONSE TO TRANSURETHRAL ALPROSTADIL, PRAZOSIN AND ALPROSTADIL-PRAZOSIN COMBINATIONS  

Microsoft Academic Search

PurposeTransurethral alprostadil has been shown to be efficacious in many men with erectile dysfunction. We compared transurethral alprostadil and prazosin alone, and in combination to treat this disorder.

CRAIG A. PETERSON; ALAN H. BENNETT; WAYNE J. G. HELLSTROM; FRAN E. KAISER; JOHN E. MORLEY; KERRY J. NEMO; HARIN PADMA-NATHAN; J. JOSEPH PRENDERGAST; PETER Y. TAM; EMIL A. TANAGHO; LESLIE K. TODD; JOHN C. VARADY; NEIL GESUNDHEIT

1998-01-01

362

Thalidomide influences growth and vasculogenic mimicry channel formation in melanoma  

PubMed Central

Aims To observe the effects of thalidomide on melanoma tumor growth and blood supply patterns in C57 mice. Methods Thirty mice inoculated subcutaneously with B16F10 cells were randomly divided into the treatment group and the control group. Thalidomide was administered once a day at a dose of 200 mg/kg for the treatment group starting on the fifth day after inoculation, and an equivalent volume of 0.5% carboxylmethyl cellulose was administered similarly in the control group. The diameter of the tumors was measured daily after inoculation until the mice were sacrificed on the 19th day. The different blood supply patterns were counted after immunohistochemical and PAS histochemical double-Staining. VEGF, NF-?B, PCNA, MMP-2 and MMP-9 expression in tumor tissue was also assessed. Results The tumor volume(P = 0.019) and the number of vasculogenic mimicry(P = 0.03) and mosaic vessels(P = 0.004) in the treatment group were significantly decreased compared with the control group. VEGF(P = 0.004), NF-?B(P = 0.009), PCNA(P = 0.002), MMP-2 (P = 0.000), MMP-9(P = 0.002) protein expression and MMP-2(P = 0.000) and MMP-9(P = 0.000) mRNA in the treatment group were significantly lower than those in the control groups. Conclusion Thalidomide inhibits vasculogenic mimicry channel and mosaic vessels formation in melanoma through the regulation of vasculogenic factors, and it can induce necrosis of melanoma cells, which may be related with the NF-?B signaling pathway.

Zhang, Shiwu; Li, Man; Gu, Yanjun; Liu, Zhiyong; Xu, Shaoyan; Cui, Yanfeng; Sun, Baocun

2008-01-01

363

Vasculogenic mimicry of acute leukemic bone marrow stromal cells.  

PubMed

Angiogenesis is thought to be involved in the development of acute leukemia (AL). We investigated whether bone marrow stromal cells (BMSCs) derived from stem cells might be responsible for the increase in microvascular density (MVD), and compared 13 bone marrow samples from AL patients with 23 samples from patients in complete remission (controls). We demonstrated that AL-derived BMSC secreted more insulin growth factor-1 (IGF-1) and SDF-1alpha than controls. In addition, in contrast to normal adherent BMSCs, adherent BMSCs derived from CD133+/CD34+ stem cells from AL patients were able to form capillary-like structures ('vasculogenic mimicry') on Matrigel. The increase in vasculogenic mimicry occurred through PI3 kinase and rho GTPase pathway as inhibitors of these signaling pathways (wortmannin and GGTI-298, respectively) were able to reduce or prevent capillary tube formation. In normal BMSC, addition of exogenous IGF-1 generated capillary-like tubes through the same pathway as observed spontaneously in AL-derived BMSC. The involvement of IGF-1 in the mimicry process was confirmed by the addition of a neutralizing antibody against IGF-1R or a IGF-1R pathway inhibitor (picropodophyllin). In conclusion, AL-derived BMSC present functional abnormalities that may explain the increase in MVD in the bone marrow of AL patients. PMID:19340002

Mirshahi, P; Rafii, A; Vincent, L; Berthaut, A; Varin, R; Kalantar, G; Marzac, C; Calandini, O A; Marie, J-P; Soria, C; Soria, J; Mirshahi, M

2009-04-02

364

Erectile Dysfunction: Viagra and Other Oral Medications  

MedlinePLUS

... told no prescription is necessary. Some illegal businesses sell counterfeit versions of legitimate medications, which can be ... it might help you achieve a more satisfying sex life. For some men, Viagra, Levitra and Cialis ...

365

[Male sexual dysfunction and obesity].  

PubMed

Obesity concerns more than 200 million people in the world, with an increasing prevalence in western countries. It is closely related to multiple medical conditions, such as diabetes and hypertension. It was recently shown that testosterone deficiency syndrome and erectile dysfunction (ED) are also linked to male obesity. In this group of patients, ED may be due to defects in corpus cavernosum relaxation, endocrine modifications and nerve signal alterations. Weight loss and increased physical activities can improve erectile function in 30% of obese patients. Additional medical treatments of ED enhance erectile function in more than 80% of patients. Self image improvement associated with appropriate erectile dysfunction medical treatment allow better sexual life and potentially increased motivation for weight loss. PMID:23330231

Lucca, Ilaria; Paduch, Darius A; Pralong, François; Vaucher, Laurent

2012-12-01

366

Effect of irbesartan on erectile function in patients with hypertension and metabolic syndrome  

Microsoft Academic Search

Pathogenesis of erectile dysfunction (ED) is related to endothelial dysfunction and therefore associated with cardiovascular risk factors. Patients with a combination of risk factors, as in metabolic syndrome, are thus likely to have an increased risk of developing endothelial and ED. The angiotensin receptor antagonist irbesartan has been shown to improve endothelial function in cardiovascular high-risk patients, which suggests a

M Baumhäkel; N Schlimmer; M Böhm

2008-01-01

367

Phosphodiesterase inhibitors in female sexual dysfunction  

Microsoft Academic Search

Based on the increasing knowledge on both the physiology of penile erection and the pathophysiology of erectile dysfunction,\\u000a selective phosphodiesterase (PDE) inhibitors have been successfully introduced in the oral treatment of male erectile dysfunction.\\u000a Because of their central role in smooth muscle tone regulation, PDEs remain an attractive target for drug development in urology.\\u000a Since the distribution and functional significance

Margit Mayer; Christian G. Stief; Michael C. Truss; Stefan Ückert

2005-01-01

368

Specific aspects of erectile function in urology\\/andrology  

Microsoft Academic Search

The urologist\\/andrologist is the specialist responsible for diagnosis and treatment of health problems related to the genitourinary tract, and his or her participation in comprehensive care for a patient with erectile dysfunction (ED) is fundamental and often indispensable. The urologists\\/andrologists should characterize the origin of ED because of their knowledge and familiarity of all diagnostic tests and second- and third-line

A Martin-Morales; L Rodríguez-Vela; F Meijide; J L Arrondo; J Cortada

2004-01-01

369

An Open Trial of Oral Sildenafilin Antidepressant-Induced Sexual Dysfunction  

Microsoft Academic Search

Background: Sildenafil is a selective inhibitor of cyclic GMP-specific phosphodiesterase type 5 that has been associated with greater improvement of erectile function compared to placebo among men with erectile dysfunction. The goal of our study was to evaluate its efficacy in a small sample of outpatients with antidepressant-induced sexual dysfunction. Methods: We studied the first 14 depressed outpatients (9 men

Maurizio Fava; Meridith A. Rankin; Jonathan E. Alpert; Andrew A. Nierenberg; John J. Worthington

1998-01-01

370

Neurogenne zaburzenia erekcji pochodzenia rdzeniowego Neurogenic erictile dysfunction caused by diseases and damages of spinal cord  

Microsoft Academic Search

Under the diseases and damages of spinal cord comes to series of sexual dysfunctions including erectile dysfunctions. Among other things it's caused by the break off of the nervous passage conducting from the erection center in brain (limbic system, temporal lobe, the medical pre-optic area and the paraventricular nucleus of hypothalamus) to the erection center in the spinal cord. Erectile

Marek Sawka

371

Heterogeneity in SDF-1 Expression Defines the Vasculogenic Potential of Adult Cardiac Progenitor Cells  

PubMed Central

Rationale The adult myocardium has been reported to harbor several classes of multipotent progenitor cells (CPCs) with tri-lineage differentiation potential. It is not clear whether c-kit+CPCs represent a uniform precursor population or a more complex mixture of cell types. Objective To characterize and understand vasculogenic heterogeneity within c-kit+presumptive cardiac progenitor cell populations. Methods and Results c-kit+, sca-1+ CPCs obtained from adult mouse left ventricle expressed stem cell-associated genes, including Oct-4 and Myc, and were self-renewing, pluripotent and clonogenic. Detailed single cell clonal analysis of 17 clones revealed that most (14/17) exhibited trilineage differentiation potential. However, striking morphological differences were observed among clones that were heritable and stable in long-term culture. 3 major groups were identified: round (7/17), flat or spindle-shaped (5/17) and stellate (5/17). Stellate morphology was predictive of vasculogenic differentiation in Matrigel. Genome-wide expression studies and bioinformatic analysis revealed clonally stable, heritable differences in stromal cell-derived factor-1 (SDF-1) expression that correlated strongly with stellate morphology and vasculogenic capacity. Endogenous SDF-1 production contributed directly to vasculogenic differentiation: both shRNA-mediated knockdown of SDF-1 and AMD3100, an antagonist of the SDF-1 receptor CXC chemokine Receptor-4 (CXCR4), reduced tube-forming capacity, while exogenous SDF-1 induced tube formation by 2 non-vasculogenic clones. CPCs producing SDF-1 were able to vascularize Matrigel dermal implants in vivo, while CPCs with low SDF-1 production were not. Conclusions Clonogenic c-kit+, sca-1+ CPCs are heterogeneous in morphology, gene expression patterns and differentiation potential. Clone-specific levels of SDF-1 expression both predict and promote development of a vasculogenic phenotype via a previously unreported autocrine mechanism.

Rodrigues, Claudia O.; Shehadeh, Lina A.; Hoosien, Michael; Otero, Valerie; Chopra, Ines; Tsinoremas, Nicholas F.; Bishopric, Nanette H.

2011-01-01

372

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

PubMed Central

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

Fan, Yue-Zu; Sun, Wei

2010-01-01

373

Female sexual dysfunction: State of the art  

Microsoft Academic Search

Female sexual dysfunction, a common, multifactorial, and often undertreated medical condition, attracted the attention of\\u000a the medical community with the successful introduction of medical therapy for male erectile dysfunction. This review discusses\\u000a the updated classification systems and definitions, epidemiologic aspects, and new pathophysiologic and therapeutic implications\\u000a of this sexual disorder.

Aristotelis G. Anastasiadis; Laurent Salomon; Mohamed A. Ghafar; Martin Burchardt; Ridwan Shabsigh

2002-01-01

374

Epidemiology and pathophysiology of male sexual dysfunction  

Microsoft Academic Search

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

J Kaminetsky

2008-01-01

375

Early use of vacuum constriction device following radical prostatectomy facilitates early sexual activity and potentially earlier return of erectile function  

Microsoft Academic Search

To assess the efficacy of vacuum constriction devices (VCD) following radical prostatectomy (RP) and determine whether early use of VCD facilitates early sexual activity and potentially earlier return of erectile function. This prospective study consisted of 109 patients who underwent nerve-sparing (NS) or non-nerve-sparing (NNS) RP between August 1999 and October 2001 and developed erectile dysfunction following surgery. The patients

R Raina; A Agarwal; S Ausmundson; M Lakin; K C Nandipati; D K Montague; D Mansour; C D Zippe

2006-01-01

376

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

377

Sexual Dysfunction in Parkinson's Disease  

Microsoft Academic Search

Sexual dysfunction is common in Parkinson's disease (PD). We investigated the premorbid and present sexual functioning of 75 people with PD (32 women and 43 men). Women reported difficulties with arousal (87.5%), with reaching orgasm (75.0%), with low sexual desire (46.9%), and wih sexual dissatisfaction (37.5%). Men reported erectile dysfunction (68.4%), sexual dissatisfaction (65.1%), premature ejaculation (40.6%), and difficulties reaching

GILA BRONNER; VLADIMIR ROYTER; AMOS D. KORCZYN; NIR GILADI

2004-01-01

378

Does vibration offer any advantage over visual stimulation studies (VSS) in the assessment of erectile capacity?  

Microsoft Academic Search

The purpose of this work was to determine whether vibration stimulation or erotic videotape material can provide an acceptable diagnostic yield for patients with erectile dysfunction (ED) without the patient needing to endure more explicit erotic films, which may be distasteful to some patients, or intracavernous injections, to which there may be a high inhibitory response. Ninety-five subjects were randomly

KR Wylie; D Steward; SJ Walters

2001-01-01

379

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

Microsoft Academic Search

Men with diabetes have an increased risk for erectile dysfunction (ED) than those without diabetes. The diabetes control and complications trial clearly showed that better long-term control of blood glucose in diabetes type 1 is associated with decreased frequency and delayed the onset of microvascular complications. The aim of this study is to explore the role of glycemic control, and

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

2010-01-01

380

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

Microsoft Academic Search

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

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

2009-01-01

381

A double-blind, placebo-controlled evaluation of the erectile response to transurethral alprostadil  

Microsoft Academic Search

ObjectivesPrevious studies have indicated that the urethra may provide an effective route for administering vasoactive medication for the treatment of erectile dysfunction. We evaluated the safety and efficacy of alprostadil administered intraurethrally at home for the treatment of this disorder.

Wayne J. G. Hellstrom; Alan H. Bennett; Neil Gesundheit; Fran E. Kaiser; Tom F. Lue; Harin Padma-Nathan; Craig A. Peterson; Peter Y. Tam; Leslie K. Todd; John C. Varady

1996-01-01

382

[Selective microsurgical therapy in vascular-induced erectile impotence].  

PubMed

Patients with erectile dysfunction should be subjected to a complex and complete diagnostic procedure, including selective pharmaco-phalloangiography and dynamic pharmacocavernosonography only when SKAT has failed and after the exclusion of neurological disorders. Patients being offered these invasive procedures should be highly motivated and willing to undergo surgical correction of the vascular origin of their erectile impotence. If peripheral vascular occlusive disease is found affecting the pelvic arteries, the best operative technique must be selected. In our opinion, this decision should be made intraoperatively after visualization of the dissected dorsal penile vessels. Use of the Doppler probe can be extremely helpful during the operation. Intraoperative findings on the degree of arteriosclerosis and arterial flow can differ from those allowed by preoperative diagnostic procedures. Penile erectile function was restored in seven of nine patients after penile revascularization performed under microsurgical conditions. We used the operative methods described by Virag and Hauri, applying our own modification of the Hauri procedure in two patients. With careful selection of patients and methods it should be possible to resolve individual patients' problems with peripheral occlusion, even though the exact hemodynamic pathology remains obscure. PMID:3043879

Sohn, M; Sikora, R; Deutz, F J; Bohndorf, K; Günther, R

1988-05-01

383

Laparoscopic mobilization of the inferior epigastric artery for penile revascularization in vasculogenic impotence.  

PubMed

A laparoscopic approach was used for penile revascularization in a patient with vasculogenic impotence to avoid the long abdominal incision which was traditionally required to harvest the inferior epigastric artery as a neoarterial source. Despite the time-consuming nature of laparoscopy, this procedure was as efficacious but less morbid and required less convalescence than open revascularization. Whether more patients may benefit from this procedure must be evaluated in further studies. PMID:9250921

Moon, Y T; Kim, S C

1997-06-01

384

Role of Twist in vasculogenic mimicry formation in hypoxic hepatocellular carcinoma cells in vitro  

Microsoft Academic Search

Vasculogenic mimicry (VM) refers to the unique ability of highly aggressive human tumor cells to form matrix-rich networks de novo when cultured on a three-dimensional matrix, thus mimicking embryonic vasculogenesis. Some studies have shown that tumor hypoxia can promote tumor cells to form vessel-like tubes in vitro and express genes associated with VM. Although, the mechanisms involved in hypoxia-induced VM

Ma Jin-lu; Han Su-xia; Zhu Qing; Zhao Jing; Zhang Dan; Wang Li; Lv Yi

2011-01-01

385

Sildenafil Preserves Intracorporeal Smooth Muscle After Radical Retropubic Prostatectomy  

Microsoft Academic Search

PurposeEarly use of vasoactive agents has been shown to rehabilitate erectile function after nerve sparing radical retropubic prostatectomy (RRP). The loss of intracorporeal smooth muscle (SM) and an increase in intracorporeal fibrosis have been demonstrated in vasculogenic impotence and implicated in permanent post-RRP erectile dysfunction. We assessed the effect of sildenafil on SM content after RRP.

ERIC J. SCHWARTZ; PHILIP WONG; R. JAMES GRAYDON

2004-01-01

386

Determination of area of leak in venogenic impotence: a mathematical model  

Microsoft Academic Search

Erectile dysfunction is an increasing medical problem, affecting up to 50% of men. Most cases are vasculogenic and most of these stem from the inability of the penis to store blood during erection due to venous leak. The area of leakage during erection could be the most direct measure of erectile function but has not been investigated before. We developed

Margot S. Damaser; John P. Mulhall

1997-01-01

387

The role of TG2 in ECV304-related vasculogenic mimicry.  

PubMed

Tumour vasculogenesis can occur by a process referred to as vasculogenic mimicry, whereby the vascular structures are derived from the tumour itself. These tumours are highly aggressive and do not respond well to anti-angiogenic therapy. Here, we use the well characterised ECV304 cell line, now known as the bladder cancer epithelial cell line T24/83 which shows both epithelial and endothelial characteristics, as a model of in vitro vasculogenic mimicry. Using optimised ratios of co-cultures of ECV304 and C378 human fibroblasts, tubular structures were identifiable after 8 days. The tubular structures showed high levels of TG2 antigen and TG in situ activity. Tubular structures and in situ activity could be blocked either by site-directed irreversible inhibitors of TG2 or by silencing the ECV304 TG2 by antisense transfection. In situ activity for TG2 showed co-localisation with both fibronectin and collagen IV. Deposition of these proteins into the extracellular matrix could be reduced by inclusion of non-cell penetrating TG inhibitors when analysed by Western blotting suggesting that the contribution of TG2 to tube formation is extracellular. Incubation of ECV304 cells with these same irreversible inhibitors reduced cell migration which paralleled a loss in focal adhesion assembly, actin cytoskeleton formation and fibronectin deposition. TG2 appears essential for ECV304 tube formation, thus representing a potential novel therapeutic target in the inhibition of vasculogenic mimicry. PMID:22231926

Jones, Richard A; Wang, Zhuo; Dookie, Shakthi; Griffin, Martin

2012-01-10

388

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

389

Persistent Sexual Dysfunction after Discontinuation of Selective Serotonin Reuptake Inhibitors  

Microsoft Academic Search

A B S T R A C T Introduction. Sexual dysfunctions such as low libido, anorgasmia, genital anesthesia, and erectile dysfunction are very common in patients taking selective serotonin reuptake inhibitors (SSRIs). It has been assumed that these side effects always resolve after discontinuing treatment, but recently, four cases were presented in which sexual function did not return to baseline.

Antonei Csoka; Audrey Bahrick; Olli-Pekka Mehtonen

2008-01-01

390

Sexual dysfunctions in men treated for testicular cancer - secondary publication  

Microsoft Academic Search

Patients treated for testicular cancer have increased risk of ejaculatory, orgas- mic and erectile dysfunction compared with healthy men. The underlying relations are unclear. This review describes sexual dysfunctions that are asso- ciated with various treatment modalities. A metaanalysis and 11 original works were examined. About one third of the patients experience one or more sexual problems in relation to

Susanne Rosendal; Annamaria G. E. Giraldi

391

Obesity, the metabolic syndrome, and sexual dysfunction  

Microsoft Academic Search

Sexual problems in both sexes appear to be widespread in society, influenced by both health-related and psychosocial factors, and are associated with impaired quality of life. Epidemiological studies suggest that modifiable health behaviors, including physical activity and leanness, are associated with a reduced risk for erectile dysfunction (ED) among men. Data from other surveys also indicate a higher prevalence of

K Esposito; D Giugliano

2005-01-01

392

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.

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

2013-01-01

393

A new perspective of vasculogenic mimicry: EMT and cancer stem cells (Review)  

PubMed Central

Vasculogenic mimicry (VM), a new pattern of tumor microcirculation, is important for the growth and progression of tumors. Epithelial-mesenchymal transition (EMT) is pivotal in malignant tumor progression and VM formation. With increasing knowledge of cancer stem cell (CSC) phenotypes and functions, increasing evidence suggests that CSCs are involved in VM formation. Recent studies have indicated that EMT is relevant to the acquisition and maintenance of stem cell-like characteristics. Thus, in this review we discuss the correlation between CSCs, EMT and VM formation.

FAN, YUN-LONG; ZHENG, MIN; TANG, YA-LING; LIANG, XIN-HUA

2013-01-01

394

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.

Avasthi, Ajith; Biswas, Parthasarathy

2004-01-01

395

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

PubMed

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

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

2011-09-22

396

Recurrent pancreatic arteritis and vasculogenic relapsing pancreatitis in rheumatoid arthritis - a retrospective clinicopathologic and immunohistochemical study of 161 autopsy patients.  

PubMed

The aim of this study was to determine: the prevalence, and histological characteristics of vasculitis in the pancreas, and to follow the formal pathogenesis of multifocal pancreatitis due to arteritis and/or arteriolitis (multifocal vasculogenic pancreatitis). A randomized autopsy population of 161 in-patients with rheumatoid arthritis (RA) was studied. Systemic vasculitis (SV) complicated RA in 36 (22.36%) of 161 cases; tissue samples of pancreas were available for histologic evaluation in 28 patients. Pancreatitis and vasculitis were characterized histologically and immunohistochemically. Vasculogenic, multifocal pancreatitis was not recognized clinically. Vasculitis of the pancreatic arterioles and small arteries (branches of splenic artery, upper and lower gastroduodenal arteries) can lead to local ischaemia and to regressive changes in the pancreas. This vasculogenic process is more or less widespread and multifocal, depending on the number of involved vessels and is followed by reactive inflammation, depending on the stages of the pathological process. Because of the recurrent nature of vasculitis with time these regressive changes accumulate within the pancreas and may contribute to an unexpected circulatory failure and sudden death of the patient. Vasculogenic microinfarcts in the pancreas may be clinically characterized by unexplained recurrent abdominal symptoms and spontaneous remissions which insidiously may lead to metabolic failure resistant to therapy. PMID:18975138

Bély, Miklós; Apáthy, Agnes

2008-10-31

397

Tx2-6 toxin of the Phoneutria nigriventer spider potentiates rat erectile function?  

PubMed Central

The venom of the spider Phoneutria nigriventer contains several toxins that have bioactivity in mammals and insects. Accidents involving humans are characterized by various symptoms including penile erection. Here we investigated the action of Tx2-6, a toxin purified from the P. nigriventer spider venom that causes priapism in rats and mice. Erectile function was evaluated through changes in intracavernosal pressure/mean arterial pressure ratio (ICP/MAP) during electrical stimulation of the major pelvic ganglion (MPG) of normotensive and deoxycorticosterone-acetate (DOCA)-salt hypertensive rats. Nitric oxide (NO) release was detected in cavernosum slices with fluorescent dye (DAF-FM) and confocal microscopy. The effect of Tx2-6 was also characterized after intracavernosal injection of a non-selective nitric oxide synthase (NOS) inhibitor, L-NAME. Subcutaneous or intravenous injection of Tx2-6 potentiated the elevation of ICP/MAP induced by ganglionic stimulation. L-NAME inhibited penile erection and treatment with Tx2-6 was unable to reverse this inhibition. Tx2-6 treatment induced a significant increase of NO release in cavernosum tissue. Attenuated erectile function of DOCA-salt hypertensive rats was fully restored after toxin injection. Tx2-6 enhanced erectile function in normotensive and DOCA-salt hypertensive rats, via the NO pathway. Our studies suggest that Tx2-6 could be important for development of new pharmacological agents for treatment of erectile dysfunction.

Nunes, K.P.; Costa-Goncalves, A.; Lanza, L.F.; Cortes, S.F.; Cordeiro, M.N.; Richardson, M.; Pimenta, A.M.C.; Webb, R.C.; Leite, R.; De Lima, M.E.

2011-01-01

398

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

399

Stem cells: novel players in the treatment of erectile dysfunction  

Microsoft Academic Search

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

Haiyang Zhang; Maarten Albersen; Xunbo Jin; Guiting Lin

2012-01-01

400

Prevalence of Erectile Dysfunction among Treated Hypertensive Males  

Microsoft Academic Search

Result: Of the 429 patients (mean age of 57.5 + 12.0 years) interviewed, 241 cases (56.2%) reported ED. The prevalence was found to increase with age: from 0% in men aged < 40 years, 47.4% in men aged 40 - 59 years, and 75.3% in men aged > 60 years. Risk of ED was significantly (p < 0.01) associated with

Peera Buranakitjaroen

401

Erectile Dysfunction - Impotence: Questions to Discuss with Your Doctor  

MedlinePLUS

? Harvard Health Publications ? Order the Book ? Contact Us Sign up for our free e-mail newsletter, HEALTHbeat . ... or partial erections. ©2000–2006 President & Fellows of Harvard College Sign Up Now For HEALTH beat Our ...

402

Animal Models for the Study of Erectile Function and Dysfunction  

Microsoft Academic Search

\\u000a The mechanisms of penile erection have been investigated using animal models from the beginning of modern investigative physiology.\\u000a In 1863, Eckhard reported that electrical stimulation of the nervi erigentes (pelvic nerves) induced penile erection in the\\u000a anesthetized dog. This study identified that erection is a vasodilatory event. Over 125 years of animal experimentation passed\\u000a before the vasodilatory neurotransmitter was identified

Kevin E. McKenna

403

Internet websites selling herbal treatments for erectile dysfunction  

Microsoft Academic Search

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.

R Thurairaja; B Barrass; R Persad

2005-01-01

404

[Electromyograms in erectile dysfunction and computer-assisted interpretation].  

PubMed

The electromyogram of the corpora cavernosa (CC-EMG) provides information on the autonomic innervation and/or smooth musculature. The interpretation of the CC-EMG, usually by evaluating signal patterns of higher activity, is time-consuming. To improve this situation, a computer-aided diagnosis employing a Microsoft Windows user interface was developed. The computer-aided interpretation is based on digital measurement data obtained using a 170.6 Hz sampling frequency and quantization of 10 V/12 bits of the signal. The first task of the program is to extract signal patterns of higher activity from stored data. To describe these patterns in mathematical terms, the features "relative time position", "relative reproducibility", "portion of normal phases", and "portion of whip phases" are calculated. Characteristic signal forms (normal and whip phases) are identified by means of syntactic pattern recognition. Using fuzzy logic, the features are used to effect pattern evaluation. To summarize the evaluated patterns, the variable "global normality" has been established, and linked to the "global synchronicity" at a second fuzzy logic level, to produce the final diagnosis. Finally, 30 records were evaluated independently by a team of experts and by the computer program. In relation to four established diagnostic classes, a correspondence of 70% was found. Furthermore, the accuracy achieved in each of the individual classes was better than 50%. Discrimination between normal and abnormal evaluation, which is of particular interest, reached 80%. PMID:9181828

Gorek, M; Hartung, C; Stief, C G

1997-03-01

405

[Tadalafil and patients preference in the treatment of erectile dysfunction].  

PubMed

ED treatment has changed fundamentally since phosphodiesterase type 5 inhibitor (PDE5-I) came into clinical use. There are three kinds of PDE5-I available at present, Sildenafil, Vardenafil and Tadalafil. Tadalafil distinguishes from the other two by its uniquely long half-life, which lasts 17.5h, which a pharmacodynamic duration of 36h and not influenced by food and alcohol. Thus it may enable ED patients to accomplish a spontaneous intercourse without the need of prior preparation without, which can boost their confidence and self-esteem and, the most important, improve the relationship with their partner. To know patient preference counts quite a lot in optimizing the medication ED treatment. PMID:17201266

Hu, Jian-lin; Chen, Bin

2006-12-01

406

Gene therapy treatments for erectile and bladder dysfunction  

Microsoft Academic Search

The postgenomic age presents many exciting challenges and opportunities for the application of molecular medicine to the treatment\\u000a of lower urinary tract diseases. Chief among these are the therapeutic possibilities afforded to selectively modulate\\/alter\\u000a gene expression in somatic cells to “normalize” aberrant cellular responses to the existing hormonal milieu. In this paper,\\u000a this therapeutic strategy will be referred to as

George J. Christ

2004-01-01

407

Relationship between hearing loss and sexual dysfunction.  

PubMed

Objective: Deafness may be one of the factors that leads to a change in sexual function. This study aimed to assess sexual function, in particular erectile dysfunction, in male patients with hearing loss. Materials and methods: We studied two groups: (1) adult men with acquired, bilateral, sensorineural hearing loss, and (2) healthy, adult, married men demonstrated to have normal hearing levels, as the control group. Sexual function was assessed using the International Index of Erectile Functions questionnaire, and quality of life using the 36-Item Short-Form Health Survey. Results: There was a statistically significant difference between the groups regarding the International Index of Erectile Functions questionnaire results (p <0.001), both for each of the five questionnaire domain scores and for the total score. Conclusion: Our results indicate that men with mild or moderate sensorineural hearing loss have poorer sexual health. PMID:23253624

Bak?r, S; Penbegül, N; Gün, R; Yorgancilar, E; Kini?, V; Ozbay, M; Atar, M; Güne?, M

2012-12-20

408

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

Microsoft Academic Search

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

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

2009-01-01

409

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.

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

2012-01-01

410

A pilot histomorphology and hemodynamic of vasculogenic mimicry in gallbladder carcinomas in vivo and in vitro  

PubMed Central

Background Vasculogenic mimicry (VM), as a new blood supply for tumor growth and hematogenous metastases, has been recently described in highly aggressive human melanoma cells, etc. We previously reported VM in human gallbladder carcinomas and its clinical significance. In this study, we further studied histomorphology and hemodynamic of VM in gallbladder carcinomas in vivo and in vitro. Methods The invasive potential of human gallbladder carcinoma cell lines GBC-SD and SGC-996 were identified by Transwell membrane. The vasculogenic-like network structures and the signal intensities i.e. hemodynamic in gallbladder carcinomas stimulated via the three-dimensional matrix of GBC-SD or SGC-996 cells in vitro, the nude mouse xenografts of GBC-SD or SGC-996 cells in vivo were observed by immunohistochemistry (H&E staining and CD31-PAS double staining), electron microscopy and micro-MRA with HAS-Gd-DTPA, respectively. Results Highly aggressive GBC-SD or poorly aggressive SGC-996 cells preconditioned by highly aggressive GBC-SD cells could form patterned networks containing hollow matrix channels. 85.7% (6/7) of GBC-SD nude mouse xenografts existed the evidence of VM, 5.7% (17/300) channels contained red blood cells among these tumor cell-lined vasculatures. GBC-SD xenografts showed multiple high-intensity spots similar with the intensity observed at tumor marginal, a result consistent with pathological VM. Conclusions VM existed in gallbladder carcinomas by both three-dimensional matrix of highly aggressive GBC-SD or poorly aggressive SGC-996 cells preconditioned by highly aggressive GBC-SD cells in vitro and GBC-SD nude mouse xenografts in vivo.

2011-01-01

411

Urinary Dysfunction  

MedlinePLUS

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

412

New insights on arthropod toxins that potentiate erectile function.  

PubMed

The use of natural substances for the treatment of diseases or injuries is an ancient practice of many cultures. According to folklore, natural aphrodisiacs may help to raise libido and increase desire. The supposed aphrodisiacs mainly include a plethora of preparations of plants, among other substances. However, the real boundary between myth and reality has not been established yet in most cases and such boundaries must be drawn by scientific methods. A growing interest of the scientific community has been focused on animal venoms, especially those from arthropods, i.e. spiders and scorpions, which cause priapism, a prolonged and painful erection. This review highlights the studies that have been performed with venoms and toxins from arthropods known to cause priapism, among other toxic symptoms, pointing out some pharmacological approaches for better understanding this effect. To date, the venom of some spiders, mainly Phoneutria nigriventer, and scorpions, such as the yellow South American scorpion Tityus serrulatus, among others, have been known to cause priapism. Since erectile dysfunction (ED) is a growing health problem in the world, more common in patients with vascular diseases as diabetes and hypertension, the use of animal venoms and toxins as pharmacological tools could not only shed light to the mechanisms involved in erectile function, but also represent a possible model for new drugs to treat ED. Unfortunately, attempts to correlate the structure of those priapism-related toxins were unfruitful. Such difficulties lie firstly on the poor data concerning purified priapism-related toxins, instead of whole venoms and/or semi-purified fractions, and secondly, on the scarce available primary sequences and structural data, mainly from spider toxins. It has been shown that all these toxins modify the sodium (Na(+)) channel activity, mostly slowing down its inactivation current. Improving the knowledge on the tertiary structure of these toxins could provide a key in the search of a new drug for ED treatment. PMID:23583324

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

2013-04-10

413

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

PubMed Central

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

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

2008-01-01

414

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

415

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

Microsoft Academic Search

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

Daniel Max Schmid; Brigitte Schurch; Dieter Hauri

2000-01-01

416

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

417

Treatment of homosexual and heterosexual sexual dysfunction in male-only groups of mixed sexual orientation  

Microsoft Academic Search

Males complaining of erectile and ejaculatory dysfunctions were treated in a structured therapy program. Twenty-one males of heterosexual, homosexual, or bisexual orientation were divided into five groups, with two male therapists for each group. Patients were those usually considered difficult to treat in that 16 had a primary sexual dysfunction with an average duration of 6 years. Extensive evaluations were

Walter Everaerd; Joost Dekker; Johan Dronkers; Kees van der Rhee; Joel Staffeleu; Guus Wiselius

1982-01-01

418

Therapy Insight: sexual and bladder dysfunction associated with diabetes mellitus  

Microsoft Academic Search

Diabetes mellitus affects 3–6% of the population. Patients with diabetes experience chronic vascular complications, which lead to a wide range of medical problems. Genitourinary problems are included among these complications, related to both neuropathy and vasculopathy. The most important clinical features relating to genitourinary involvement in patients with diabetes include erectile dysfunction (ED) and retrograde ejaculation in men, and bladder

Domenico Fedele

2005-01-01

419

Sexual dysfunction in the patient with prostatitis  

Microsoft Academic Search

Prostatitis (chronic prostatitis\\/chronic pelvic pain syndrome [CP\\/CPPS]) is a common condition in men that accounts for a\\u000a significant number of visits to a medical doctor or urologist. It is one of the most widely diagnosed conditions in men who\\u000a attend urologic clinics. Erectile dysfunction, defined as the consistent inability to obtain and\\/or maintain a penile erection\\u000a sufficient for adequate sexual

Alexander Müller; John P. Mulhall

2006-01-01

420

[Heart failure and sexual dysfunction].  

PubMed

Most patients with chronic heart failure (CHF) can safely engage in sexual activity and be treated for erectile dysfunction with sildenafil, provided that they do not have active coronary ischemia and do not require treatment with nitrates. Clinicians should know the physiological requirements for sexual activity and the impact chronic heart failure has on sexual performance. Fear of cardiac events during intercourse can interfere with patients' ability to perform and enjoy sex, and thus, it is important that the physician be able to counsel patients with chronic heart failure about sexual activity. PMID:18476642

Sekoranja, L; Bianchi-Demicheli, F; Gaspoz, J M; Mach, F

2008-03-26

421

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.

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

2011-01-01

422

Erectile Function Durability Following Permanent Prostate Brachytherapy  

SciTech Connect

Purpose: To evaluate long-term changes in erectile function following prostate brachytherapy. Methods and Materials: This study included 226 patients with prostate cancer and preimplant erectile function assessed by the International Index of Erectile Function-6 (IIEF-6) who underwent brachytherapy in two prospective randomized trials between February 2001 and January 2003. Median follow-up was 6.4 years. Pre- and postbrachytherapy potency was defined as IIEF-6 >= 13 without pharmacologic or mechanical support. The relationship among clinical, treatment, and dosimetric parameters and erectile function was examined. Results: The 7-year actuarial rate of potency preservation was 55.6% with median postimplant IIEF of 22 in potent patients. Potent patients were statistically younger (p = 0.014), had a higher preimplant IIEF (p < 0.001), were less likely to be diabetic (p = 0.002), and were more likely to report nocturnal erections (p = 0.008). Potency preservation in men with baseline IIEF scores of 29-30, 24-28, 18-23, and 13-17 were 75.5% vs. 73.6%, 51.7% vs. 44.8%, 48.0% vs. 40.0%, and 23.5% vs. 23.5% in 2004 vs. 2008. In multivariate Cox regression analysis, preimplant IIEF, hypertension, diabetes, prostate size, and brachytherapy dose to proximal penis strongly predicted for potency preservation. Impact of proximal penile dose was most pronounced for men with IIEF of 18-23 and aged 60-69. A significant minority of men who developed postimplant impotence ultimately regained erectile function. Conclusion: Potency preservation and median IIEF scores following brachytherapy are durable. Thoughtful dose sparing of proximal penile structures and early penile rehabilitation may further improve these results.

Taira, Al V. [Department of Radiation Oncology, University of Washington, Seattle, WA (United States); Merrick, Gregory S., E-mail: gmerrick@urologicresearchinstitute.or [Schiffler Cancer Center, Wheeling Jesuit University, Wheeling, West Virginia (United States); Galbreath, Robert W.; Butler, Wayne M. [Schiffler Cancer Center, Wheeling Jesuit University, Wheeling, West Virginia (United States); Wallner, Kent E. [Puget Sound Healthcare Corporation, Group Health Cooperative, University of Washington, Seattle, WA (United States); Kurko, Brian S.; Anderson, Richard; Lief, Jonathan H. [Schiffler Cancer Center, Wheeling Jesuit University, Wheeling, West Virginia (United States)

2009-11-01

423

Lower urinary tract symptoms, benign prostatic hyperplasia, and sexual dysfunction  

Microsoft Academic Search

Previously viewed as independent processes, sexual dysfunction (SD) and lower urinary tract symptoms (LUTS) frequently associate\\u000a and significantly detract from overall quality of life for men. Analysis of historic and emerging literature using some of\\u000a the Bradford-Hill criteria argues causality between the two disease processes, with most data focusing on the interplay between\\u000a LUTS and erectile dysfunction. Understanding of the

Jonathan K. Park; Tobias S. Köhler; Kevin T. McVary

2008-01-01

424

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

PubMed Central

Background The molecular mechanisms responsible for the survival and preservation of function for adult parasympathetic ganglion neurons following injury remain incompletely understood. However, advances in the neurobiology of growth factors, neural development, and prevention of cell death have led to a surge of clinical interest for protective and regenerative neuromodulatory strategies, as surgical therapies for prostate, bladder, and colorectal cancers often result in neuronal axotomy and debilitating loss of sexual function or continence. In vitro studies have identified neurturin, a glial cell line-derived neurotrophic factor, as a neuromodulator for pelvic cholinergic neurons. We present the first in vivo report of the effects of neurturin upon the recovery of erectile function following bilateral cavernous nerve crush injury in the rat. Methods In these experiments, groups (n = 8 each) consisted of uninjured controls and animals treated with injection of albumin (blinded crush control group), extended release neurotrophin-4 or neurturin to the site of cavernous nerve crush injury (100 ?g per animal). After 5 weeks, recovery of erectile function (treatment effect) was assessed by cavernous nerve electrostimulation and peak aortic pressures were measured. Investigators were unblinded to specific treatments after statistical analyses were completed. Results Erectile dysfunction was not observed in the sham group (mean maximal intracavernous pressure [ICP] increase of 117.5 ± 7.3 cmH2O), whereas nerve injury and albumin treatment (control) produced a significant reduction in ICP elevation of 40.0 ± 6.3 cmH2O. Neurturin facilitated the preservation of erectile function, with an ICP increase of 55% at 62.0 ± 9.2 cmH2O (p < 0.05 vs control). Extended release neurotrophin-4 did not significantly enhance recovery of erectile function with an ICP change of 46.9 ± 9.6. Peak aortic blood pressures did not differ between groups. No significant pre- and post-treatment weight differences were observed between control, neurotrophin-4 and neurturin cohorts. All animals tolerated the five-week treatment course. Conclusion Treatment with neurturin at the site of cavernous nerve crush injury facilitates recovery of erectile function. Results support further investigation of neurturin as a neuroprotective and/or neuroregenerative agent facilitating functional recovery after cavernous or other pelvic autonomic nerve injuries.

Bella, Anthony J; Fandel, Thomas M; Tantiwongse, Kavirach; Brant, William O; Klein, Robert D; Garcia, Carlos A; Lue, Tom F

2007-01-01

425

Angiogenic and vasculogenic factors in the vitreous from patients with proliferative diabetic retinopathy.  

PubMed

This study was conducted to determine levels of angiogenic and endothelial progenitor cell mobilizing (vasculogenic) factors in vitreous fluid from proliferative diabetic retinopathy (PDR) patients and correlate their levels with clinical disease activity. Vascular endothelial growth factor (VEGF), soluble vascular endothelial growth factor receptor-2 (sVEGFR-2), stem cell factor (SCF), soluble c-kit (s-kit), endothelial nitric oxide synthase (eNOS), and prostaglandin E2 (PGE2) levels were measured by ELISA in vitreous samples from 34 PDR and 15 nondiabetic patients. eNOS was not detected. VEGF, sVEGFR-2, SCF, and s-kit levels were significantly higher in PDR with active neovascularization compared with quiescent PDR and nondiabetic patients (P < 0.001; 0.007; 0.001; <0.001, resp.). In contrast, PGE2 levels were significantly higher in nondiabetic patients compared with PDR patients (P < 0.001). There were significant correlations between levels of sVEGFR-2 versus SCF (r = 0.950, P < 0.001), sVEGFR-2 versus s-kit (r = 0.941, P < 0.001), and SCF versus s-kit (r = 0.970, P < 0.001). Our findings suggest that upregulation of VEGF, sVEGFR-2, SCF, and s-kit supports the contributions of angiogenesis and vasculogenesis in pathogenesis of PDR. PMID:23671874

Abu El-Asrar, Ahmed M; Nawaz, Mohd Imtiaz; Kangave, Dustan; Mairaj Siddiquei, Mohammed; Geboes, Karel

2013-03-10

426

Genital self-mutilation in erectile disorder  

PubMed Central

The majority of cases of genital self-mutilation reported in the literature have been in patients with psychosis. We report an unusual case of genital self-mutilation in erectile disorder. It is suggested that genital self-mutilation may be a pathway out of diverse psychological disorders and in non-psychotic cases it could be an expression of a psychotic solution to a conflict and may be influenced by cultural factors.

Sudarshan, C.Y.; Rao, K. Nagaraja; Santosh, S.V.

2006-01-01

427

Erectile Function Preservation for Men with Cancer  

Microsoft Academic Search

\\u000a Cancer is a major health concern in the United States and in other countries: not only is cancer the second leading cause\\u000a of death in the United States, accounting for one of every four deaths, but also its treatment may be associated with significant\\u000a morbidity [1]. Cancers involving the male pelvic organs and their treatments are ­notoriously associated with erectile

Raanan Tal; John P. Mulhall

428

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.

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

2013-01-01

429

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

PubMed

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

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

2013-04-26

430

The relevance of the dual control model to male sexual dysfunction: the Kinsey Institute\\/BASRT collaborative project  

Microsoft Academic Search

The recently developed SIS\\/SES scales, measuring propensity for sexual inhibition (SIS1 and SIS2) and for sexual excitation (SES), shown to be related to erectile problems in non-clinical samples, were explored in 171 men attending sexual problem clinics [n?=?146 with erectile dysfunction (ED)] and compared with an age matched non-clinical sample (n?=?446). SES and SIS1 scores in the clinic group with

John Bancroft; Debra Herbenick; Tricia Barnes; Ruth Hallam-Jones; Kevan Wylie; Erick Janssen

2005-01-01

431

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

2013-02-16

432

Glioblastoma-derived Tumor Cells Induce Vasculogenic Mimicry through Flk-1 Protein Activation*  

PubMed Central

Glioblastoma (GBM) is extremely aggressive and essentially incurable. Its malignancy is characterized by vigorous microvascular proliferations. Recent evidence has shown that tumor cells display the ability to drive blood-perfused vasculogenic mimicry (VM), an alternative microvascular circulation independent of endothelial cell angiogenesis. However, molecular mechanisms underlying this vascular pathogenesis are poorly understood. Here, we found that vascular channels of VM in GBM were composed of mural-like tumor cells that strongly express VEGF receptor 2 (Flk-1). To explore a potential role of Flk-1 in the vasculogenesis, we investigated two glioblastoma cell lines U87 and GSDC, both of which express Flk-1 and exhibit a vascular phenotype on Matrigel. Treatment of both cell lines with either Flk-1 gene knockdown or Flk-1 kinase inhibitor SU1498 abrogated Flk-1 activity and impaired vascular function. Furthermore, inhibition of Flk-1 activity suppressed intracellular signaling cascades, including focal adhesion kinase and mitogen-activated protein kinase ERK1/2. In contrast, blockade of VEGF activity by the neutralizing antibody Bevacizumab failed to recapitulate the impact of SU1498, suggesting that Flk-1-mediated VM is independent of VEGF. Xenotransplantation of SCID/Beige mice with U87 cells and GSDCs gave rise to tumors harboring robust mural cell-associated vascular channels. Flk-1 shRNA restrained VM in tumors and subsequently inhibited tumor development. Collectively, all the data demonstrate a central role of Flk-1 in the formation of VM in GBM. This study has shed light on molecular mechanisms mediating tumor aggressiveness and also provided a therapeutic target for patient treatment.

Francescone, Ralph; Scully, Steve; Bentley, Brooke; Yan, Wei; Taylor, Sherry L.; Oh, Dennis; Moral, Luis; Shao, Rong

2012-01-01

433

Diagnosis of vasculogenic impotence: Combination of penile xenon-133 washout and papaverine tests  

SciTech Connect

The present study evaluates both penile xenon-133 washout (XWT) and papaverine tests (PT) in the diagnosis of vasculogenic impotence. XWT was accomplished by subcutaneous injection of xenon-133 (1-2 mCi in 0.1 mL saline solution) into the dorsal coronal prepuce. Abnormal XWT was suggested in patients whose clearance time (T1/2) was longer than 7.5 minutes and whose penile blood flow rate (Q) was less than 6 mL/100 g tissue/min. PT was done by intracavernous injection of papaverine (60 mg in 20 mL normal saline). Abnormal PT was indicated in patients whose onset of full erection was more than ten minutes after papaverine injection and whose duration of erection was less than one hour. Ten young and 11 older normal volunteers were examined with XWT only; all showed normal results. A total of 60 impotent patients were examined with both XWT and PT and were classified into four groups: in 2 patients (3.3%) both XWT and PT were normal (group I); in 8 (13.3%) XWT was abnormal and PT normal (group II); in 14 (23.3%) XWT was normal and PT abnormal (group III); and in 36 (60%) both XWT and PT were abnormal (group IV). On further examination with bilateral hypogastric arteriography in 10 XWT-abnormal patients and on surgical correction of abnormal curvature in 5 XWT-abnormal patients, all (100%) were proved to have penile arterial insufficiency. Erection cavernosography performed in 15 PT-abnormal patients confirmed penile venous insufficiency in 80 percent. We conclude both XWT and PT are simple and effective for evaluation of the penile arterial blood flow and venous competence, respectively.

Lin, S.N.; Liu, R.S.; Yu, P.C.; Chang, L.S.; Yeh, S.H.; Kuo, J.S.

1989-07-01

434

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

PubMed Central

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

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

2011-01-01

435

[Characteristic and treatment of sexual dysfunctions in depression (part I)].  

PubMed

Sexual dysfunction in patients diagnosed with depressive disorders affect all phases of sexual response: a decline in libido, erectile dysfunction, ejaculation disorders in men and orgasm and menstruation in women. It is estimated that are present in approximately 70% of patients, affecting 23-50% of men suffering from depression and 33-90% of women. The most common symptoms include disorders of sexual arousal in women (usually in the form of excessive vaginal dryness), erectile dysfunction in men and affects both sexes abnormal orgasm (anorgasmia or delayed). Sexual dysfunction is treated as a potential side effect of antidepressant therapy. These drugs can exacerbate the symptoms of primary sexual dysfunction, and induce it in those patients who were not present before treatment. Symptoms of sexual dysfunction reduces quality of life, self-esteem, mood, and negatively affect the relationship with your partner. Most currently used antidepressants in the world leads to the occurrence of sexual dysfunction. These include monoamine oxidase inhibitors, tricyclic antidepressants, serotonin reuptake inhibitors, serotonin reuptake inhibitors and norepinephrine, and a new generation of antidepressants. SSRIs are considered to be preparations for the largest iatrogenic effect. Sexual dysfunction resulting from treatment with antidepressant among the most serious reasons for discontinuation by the patients. PMID:21991854

Ga?ecki, Piotr; Florkowski, Antoni; Depko, Andrzej; Wo?niak, Aneta; Talarowska, Monika

2011-0