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Olabiyi AA, Oboh G, Ishola AO, Adeniyi PA, Boligon AA. Tetracarpidium conophorum Müll. Arg modulates sexual behaviour and biochemical parameters relevant to sexual function in male Wistar rats. ACTA ACUST UNITED AC 2018; 26:61-68. [PMID: 30391101 DOI: 10.1016/j.pathophys.2018.10.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 10/08/2018] [Accepted: 10/16/2018] [Indexed: 01/23/2023]
Abstract
Walnut (Tetracarpidium conophorum Müll. Arg) has been reported to be an essential ingredient in folklore medicine for sexual enhancement with little scientific validation. Hence, this study investigated the effects of walnut supplemented diet on sexual behaviour and biochemical parameters relevant to erection in male Wistar rats. Forty animals used in this study were divided into five groups (n = 8); Group 1 - normal control rats fed with basal diet, Group II - rats fed diet supplemented with 10% processed walnut, Group III - rats fed diet supplemented with 10% raw walnut, Group IV - rats fed diet supplemented with 20% processed walnut and Group V - rats fed diet supplemented with 20% raw walnut. Behavioural studies (copulation tendency and anxiety) associated with sexual function, measurement of nitric oxide (NO) levels, adenosine deaminase (ADA), arginase and acetylcholinesterase (AChE) activities in the Corpus cavernosum as well as characterization of bioactive components of the nut were evaluated. Marked reductions in ADA and arginase activities and a concomitant increase (% inclusion dependent) in the level of NO as well as enhanced sexual behaviours were observed in rat fed supplemented walnut when compared to the control. Furthermore, analysis of the walnut using high performance liquid chromatography indicated the presence of some polyphenols. From our findings, it showed that walnut improves sexual behaviour and modulates activities of key enzymes relevant to erection in male rats which may justify its used in traditional medicine.
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Affiliation(s)
- Ayodeji Augustine Olabiyi
- Functional Food and Nutraceutical Unit, Biochemistry Department, Federal University of Technology, Private Mail Bag 704, Akure, 340001, Nigeria; Medical Biochemistry Department, Afe Babalola University, Ado Ekiti, Private Mail Bag 5454, Nigeria
| | - Ganiyu Oboh
- Functional Food and Nutraceutical Unit, Biochemistry Department, Federal University of Technology, Private Mail Bag 704, Akure, 340001, Nigeria.
| | - Azeez Olakunle Ishola
- Cell Biology and Neurotoxicity Unit, Department of Anatomy, Afe Babalola University, Ado-Ekiti, Nigeria
| | - Philip Adeyemi Adeniyi
- Cell Biology and Neurotoxicity Unit, Department of Anatomy, Afe Babalola University, Ado-Ekiti, Nigeria
| | - Aline Augusti Boligon
- Phytochemical Research Laboratory, Department of Industrial Pharmacy, Federal University of Santa Maria, Build 26, Room 1115, Santa Maria, CEP 97105-900, Brazil
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La dysfonction érectile, vingt ans après. SEXOLOGIES 2018. [DOI: 10.1016/j.sexol.2018.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Colson M, Cuzin B, Faix A, Grellet L, Huyghes E. Patients, partenaires et couple, dans la prise en charge de la dysfonction érectile. SEXOLOGIES 2018. [DOI: 10.1016/j.sexol.2018.01.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Nwakanma NC, Ofoedu JN. Depressive symptoms and marital adjustment among primary care patients with erectile dysfunction in Umuahia, Nigeria. S Afr J Psychiatr 2016; 22:979. [PMID: 30263170 PMCID: PMC6138087 DOI: 10.4102/sajpsychiatry.v22i1.979] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Accepted: 07/03/2016] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES The aim of this study was to investigate the relationship between erectile dysfunction (ED), marital adjustment and depression. METHODS The survey was conducted among primary care patients at Federal Medical Centre, Umuahia. Subjects were 678 married, male primary care patients; aged 20-70 years (mean age = 45 years). ED was assessed by International Index of Erectile Function 5 (IIEF-5) score, the presence of clinically significant depressive symptoms was assessed with the 5-item version of the Center for Epidemiological Studies Depression Scale (CES-D), and marital adjustment was assessed with the Revised Dyadic Adjustment Scale (RDAS). RESULTS The prevalence of probable depression by CES-D and ED by IIEF-5 score was 20.9% and 26.0%, respectively. Marital distress was rampant (62.0%) among subjects with ED (p < 0.05, χ2 = 196.58). Erectile dysfunction was associated with marital adjustment (p < 0.05). Partial correlation revealed that depression affects both ED and marital adjustment, and is closely related to both variables. CONCLUSION Partner involvement and screening for depression should be emphasised in the care of patients with ED.
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Affiliation(s)
| | - John N Ofoedu
- Department of Family Medicine, Federal Medical Centre, Umuahia, Nigeria
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Cheng QS, Liu T, Huang HB, Peng YF, Jiang SC, Mei XB. Association between personal basic information, sleep quality, mental disorders and erectile function: a cross-sectional study among 334 Chinese outpatients. Andrologia 2016; 49. [PMID: 27364774 DOI: 10.1111/and.12631] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2016] [Indexed: 12/13/2022] Open
Abstract
Male erectile dysfunction (ED) may cause anxiety and depression, while mental disorders and sleep disturbances may also be closely related to ED. However, the exact nature of their relationship remains unclear, and whether personal basic background data affect erectile function is unknown. We conducted a cross-sectional study among Chinese outpatients with ED from January 2012 to December 2014. All the men answered a questionnaire collecting information about mental health status, sleep disturbances and personal data, underwent a physical examination and had a blood sample drawn. Sleep disturbances were assessed on the basis of a 19-item version of the Pittsburgh Sleep Quality Index, which includes questions on sleep patterns during the past month. Among the 462 patients, 128 patients with alcohol abuse, diabetes, hypertension, hyperlipidaemia, psychiatric drugs, neurologic injury or abnormal hormones were excluded from the study; 86.27% and 68.66% of the patients suffered from anxiety and depression respectively. Sleep quality and anxiety symptoms significantly affected erectile function, whereas personal income and education level had no significant effects. Our study suggested that it is necessary to pay attention to the psychological status of patients with ED, especially anxiety disorder. Sleep quality may be an important factor affecting erectile function according to the personal data.
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Affiliation(s)
- Q S Cheng
- Department of Urology, Yijishan Hospital, Wannan Medical College, Wuhu, China
| | - T Liu
- Department of Sexual Medicine, Yijishan Hospital, Wannan Medical College, Wuhu, China
| | - H B Huang
- Department of Urology, Yijishan Hospital, Wannan Medical College, Wuhu, China
| | - Y F Peng
- Department of Sexual Medicine, Yijishan Hospital, Wannan Medical College, Wuhu, China
| | - S C Jiang
- Department of Urology, Yijishan Hospital, Wannan Medical College, Wuhu, China
| | - X B Mei
- Department of Urology, Yijishan Hospital, Wannan Medical College, Wuhu, China
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Psychological determinants of erectile dysfunction among middle-aged men. Int J Impot Res 2014; 27:63-8. [PMID: 25164317 DOI: 10.1038/ijir.2014.34] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Revised: 06/26/2014] [Accepted: 07/17/2014] [Indexed: 01/23/2023]
Abstract
We describe psychological determinants of erectile dysfunction (ED) among middle-aged men with no identifiable medical risk factors and compare them with a sample of young individuals. Two groups of young (⩽ 30 years, n = 59) and middle-aged men (⩾ 40 years, n = 63) who scored ⩽ 25 on the erectile functioning domain of the International Index of Erectile Functioning were enrolled. Patients were included if they had no metabolic diseases, prostate problems or external genitalia abnormalities. Patients were not included if they were smokers, excessive drinkers or took medications known to cause ED. To assess psychopathology, symptom check list 90-revised (SCL-90-R) was administered. Structural equation modeling was performed to assess the relationship between psychopathology and ED. One in five men had severe ED, and the proportion was not different between the two groups. Middle-aged men had lower scores on different SCL-90-R domains. In both age groups, somatization and interpersonal sensitivity contributed to ED. Among younger individuals, anxiety and psychosis-related domains were also associated with ED. Unique contributors to ED in middle-aged men were depression and additional questions. In conclusion, among middle-aged men, psychological factors significantly contribute to ED when no medical risk factors are present. The pattern and composition of distress depicts distinct features, not seen in young age.
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Miner M, Nehra A, Jackson G, Bhasin S, Billups K, Burnett AL, Buvat J, Carson C, Cunningham G, Ganz P, Goldstein I, Guay A, Hackett G, Kloner RA, Kostis JB, LaFlamme KE, Montorsi P, Ramsey M, Rosen R, Sadovsky R, Seftel A, Shabsigh R, Vlachopoulos C, Wu F. All men with vasculogenic erectile dysfunction require a cardiovascular workup. Am J Med 2014; 127:174-82. [PMID: 24423973 DOI: 10.1016/j.amjmed.2013.10.013] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2013] [Revised: 10/15/2013] [Accepted: 10/15/2013] [Indexed: 11/18/2022]
Abstract
An association between erectile dysfunction and cardiovascular disease has long been recognized, and studies suggest that erectile dysfunction is an independent marker of cardiovascular disease risk. Therefore, assessment and management of erectile dysfunction may help identify and reduce the risk of future cardiovascular events, particularly in younger men. The initial erectile dysfunction evaluation should distinguish between predominantly vasculogenic erectile dysfunction and erectile dysfunction of other etiologies. For men believed to have predominantly vasculogenic erectile dysfunction, we recommend that initial cardiovascular risk stratification be based on the Framingham Risk Score. Management of men with erectile dysfunction who are at low risk for cardiovascular disease should focus on risk-factor control; men at high risk, including those with cardiovascular symptoms, should be referred to a cardiologist. Intermediate-risk men should undergo noninvasive evaluation for subclinical atherosclerosis. A growing body of evidence supports the use of emerging prognostic markers to further understand cardiovascular risk in men with erectile dysfunction, but few markers have been prospectively evaluated in this population. In conclusion, we support cardiovascular risk stratification and risk-factor management in all men with vasculogenic erectile dysfunction.
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Affiliation(s)
- Martin Miner
- Departments of Family Medicine and Urology, Miriam Hospital and Brown University, Providence, RI.
| | - Ajay Nehra
- Department of Urology, Rush University, Chicago, Ill
| | | | - Shalender Bhasin
- Department of Medicine, Section of Endocrinology, Diabetes, and Nutrition, Boston University School of Medicine, Mass
| | - Kevin Billups
- Department of Urologic Surgery, University of Minnesota, Minneapolis; The James Buchanan Brady Urological Institute, The Johns Hopkins Hospital, Baltimore, Md
| | - Arthur L Burnett
- The James Buchanan Brady Urological Institute, The Johns Hopkins Hospital, Baltimore, Md
| | - Jacques Buvat
- Centre d'Etude et de Traitement de la Pathologie de l'Appareil Reproducteur et de la Psychosomatique, Lille, France
| | - Culley Carson
- Department of Surgery, Division of Urologic Surgery, University of North Carolina, Chapel Hill
| | - Glenn Cunningham
- Departments of Medicine, and Molecular & Cellular Biology, Baylor College of Medicine and St. Luke's Episcopal Hospital, Houston, Tex
| | - Peter Ganz
- Division of Cardiology, San Francisco General Hospital and University of California, San Francisco, Calif
| | | | - Andre Guay
- Center For Sexual Function/Endocrinology, Lahey Clinic Medical Center, Peabody, Mass, Tufts University School of Medicine, Boston, Mass
| | | | - Robert A Kloner
- Heart Institute, Good Samaritan Hospital and Keck School of Medicine at University of Southern California, Los Angeles
| | - John B Kostis
- Cardiovascular Institute, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ
| | | | - Piero Montorsi
- Centro Cardiologico Monzino, IRCCS, Institute of Cardiology University of Milan, Italy
| | - Melinda Ramsey
- Complete Healthcare Communications, Inc., Chadds Ford, Pa
| | - Raymond Rosen
- New England Research Institutes, Inc., Watertown, Mass
| | - Richard Sadovsky
- Department of Family Medicine, SUNY-Downstate Medical Center, Brooklyn, NY
| | - Allen Seftel
- Department of Urology, Cooper University Hospital, Camden, NJ
| | - Ridwan Shabsigh
- Division of Urology, Maimonides Medical Center, Brooklyn, NY, and College of Physicians and Surgeons of Columbia University, New York, NY
| | | | - Frederick Wu
- Andrology Research Unit, Developmental & Regenerative Biomedicine Research Group, University of Manchester, Manchester Academic Health Science Centre, Manchester Royal Infirmary, UK
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Corona G, Rastrelli G, Ricca V, Jannini EA, Vignozzi L, Monami M, Sforza A, Forti G, Mannucci E, Maggi M. Risk Factors Associated with Primary and Secondary Reduced Libido in Male Patients with Sexual Dysfunction. J Sex Med 2013; 10:1074-89. [DOI: 10.1111/jsm.12043] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Abstract
The comorbid conditions erectile dysfunction (ED) and depression are highly prevalent in men. Multiple regression analysis to control for all other predictors of ED indicate that men with high depression scores are nearly twice as likely to report ED than nondepressed men. Depression continues to be among the most common comorbid problems in men with ED, both in the community and in clinical samples. This article reviews the current knowledge about the relationship between ED and depression, the effect of treatments for depression on ED, ways to improve screening for depression, and treatment of ED in patients with this comorbidity.
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Affiliation(s)
- Michael A Perelman
- Human Sexuality Program, Payne Whitney Clinic, The New York Presbyterian Hospital, New York, NY, USA.
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Beltran L, Giami A. Processus d’interaction dans la consultation médicale : différents abords de l’impuissance masculine. SEXOLOGIES 2009. [DOI: 10.1016/j.sexol.2009.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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12
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Erectile dysfunction in diabetic males: Plausible mechanisms and management strategies. Diabetes & Metabolic Syndrome: Clinical Research & Reviews 2008. [DOI: 10.1016/j.dsx.2007.11.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Corona G, Ricca V, Bandini E, Mannucci E, Petrone L, Fisher AD, Lotti F, Balercia G, Faravelli C, Forti G, Maggi M. Association between Psychiatric Symptoms and Erectile Dysfunction. J Sex Med 2008; 5:458-68. [DOI: 10.1111/j.1743-6109.2007.00663.x] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Mana M, Cole M, Cox S, Tawil B. Human U937 monocyte behavior and protein expression on various formulations of three-dimensional fibrin clots. Wound Repair Regen 2006; 14:72-80. [PMID: 16476075 DOI: 10.1111/j.1743-6109.2005.00091.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Fibrin sealant products such as Tisseel (Baxter Healthcare Corporation) are used in hemostasis and tissue sealing. Tisseel consists of two components, a fibrinogen-containing component and thrombin, which when mixed together form a fibrin clot. There is an interest in delivering monocytes to the wound because they are known to play an important role in the wound-healing process. Therefore, we were interested in finding the best fibrin formulation for delivering monocytes by examining monocyte behavior on 3D-fibrin clots. Using standard adhesion and proliferation assays, we found that monocytes differentially adhere, proliferate, and cluster on and within the 3D-fibrin clots depending on the final fibrinogen and thrombin concentration. Moreover, using a Boyden chamber assay, we found that monocytes migrated through the 3D-fibrin clots in 1-2 days. Furthermore, the protein expression in monocytes seeded on 3D-fibrin clots for various time points varied depending on the fibrinogen and thrombin concentrations in the final 3D-fibrin clots. The above data suggest that various formulations of fibrin sealant Tisseel present a good surface for monocyte adhesion, proliferation and migration in vitro and potentially during the wound-healing process in vivo. Moreover, because the monocytes proliferated well and clustered in the 3D fibrin, Tisseel could be a good delivery vehicle for delivering monocytes into chronic wounds to overcome a healing deficiency.
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Affiliation(s)
- Miyeko Mana
- BioSurgery Division, Baxter Healthcare Corporation, Westlake Village, California 91362, USA
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Mallis D, Moysidis K, Nakopoulou E, Papaharitou S, Hatzimouratidis K, Hatzichristou D. PSYCHIATRIC MORBIDITY IS FREQUENTLY UNDETECTED IN PATIENTS WITH ERECTILE DYSFUNCTION. J Urol 2005; 174:1913-6. [PMID: 16217344 DOI: 10.1097/01.ju.0000176746.73667.3c] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE We investigated the prevalence of psychiatric morbidity in patients with erectile dysfunction (ED). MATERIALS AND METHODS Consecutive patients who attended an andrology outpatient clinic complaining of ED were recruited for study purposes. ED severity was evaluated by the International Index of Erectile Function erectile function domain score. The psychiatric diagnosis was established by a semistructured clinical interview as well as by the Mini International Neuropsychiatric Interview 5 Diagnostic and Statistical Manual of Mental Disorders-IV. The Beck Depression Inventory was also incorporated as a complementary tool to assess depressive symptom severity. RESULTS The study included 103 patients 20 to 76 years old (mean age +/- SD 47.06 +/- 14.78) with ED. Most patients were classified with moderate and severe ED (26.2% and 44.7%, respectively). A detectable psychiatric condition was present in 63.1% of the patients, including depressive disorders in 25.2%, anxiety disorders in 11.7%, depression-anxiety comorbidity in 6.8% and personality disorders in 5.8%. A positive psychiatric anamnesis was identified in 41 cases, while 24 were newly diagnosed. No significant association was found between the duration and severity of ED, and psychiatric morbidity or the severity of depressive symptoms (p > 0.05). A positive association was found between the severity of depressive symptoms and the patient tendency to discuss the problem with their partner (p < 0.01). CONCLUSIONS Psychiatric morbidity is highly prevalent in patients with ED, potentially affecting treatment outcome. Because lifetime psychological problems were reported by more than half of the patients, a psychosocial history seems mandatory. Partner support appeared to have a significant role in the patient psychological state.
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Affiliation(s)
- Dimitrios Mallis
- Center for Sexual and Reproductive Health, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Hafez ESE, Hafez SD. Erectile dysfunction: anatomical parameters, etiology, diagnosis, and therapy. ACTA ACUST UNITED AC 2005; 51:15-31. [PMID: 15764414 DOI: 10.1080/1485010490475147] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Functional anatomy of the human penis involves various parameters: cavernous tissue, covering integument, prepuce foreskin, corpora cavernosa, corpus spongiosum, glans, facia, arterial supply, venous drainage, lymph drainage, musculature, and nerve supply. Several factors affect the expression/degree of erectile dysfunction (ED) endocrine profile, aging/senescence, demyelinating diseases, and surgery. Risk factors of ED are: age, vascular factors, metabolic diseases (diabetes mellitus), neurologic diseases, and HIV/AIDS. Several drugs are associated with ED: antiandrogenic, anticholinergic, antidepressants, antihypertensive, major tranquilizers, anxiolytics, and certain medicines/metabolites. The International Index of Erectile Function (IIEF) is a multidimensional scale for assessment of erectile dysfunction. The main structures mediating erection are the corpora cavernosa or "erectile bodies," which are fused distally for approximately three-quarters of their length. They separate proximally to fuse with each ischial tuberosity of the pelvis. On their ventral surface lies the corpus spongiosum, which surrounds the urethra. Coital dysfunction is classified into "erectile dysfunction" (psychosexual and endocrine/neuro-endocrine) and "ejaculatory dysfunction" (psychosexual, and genitourinary surgery). Vasculogenic impotence was evaluated by high-resolution ultrasonography and pulsed Doppler spectrum analysis. Cavernosal, alpha-blockade is a technique used to evaluate and treat ED. Another diagnostic procedure for ED involves color floro and spectural Doppler imaging after papaverine-induced erection in impotent men. Color Doppler and duplex ultrasonography are used to evaluate Peyronie's disease. Sildenafil cilrate (Viagra) is an effective therapy of ED in men. Vardenavil is a highly selective phosphodiesterase 5 (PDE5) inhibitor which improved ED. Prostagland E1, vasoactive intestinal polypeptide (VIP), and phentolamine mesylate (administered by autoinjectors) have been applied to treat ED in patients resistant to other intracavernosal agents. Clinical trials were conducted on self-injection of vasoactive drugs, apomorphine SL, and tadalafil in diabetic men. Medical therapy of ED includes: medicated urethral system for erection (MUSE), intravenous pharmacotherapy, arterial revascularization, vacuum devices, two- and three-component inflatable penile prosthesis, semi-rigid penile prosthesis in situ, and inflatable one-piece penile prosthesis. Surgical therapy include procedures to correct Peyronie's penile deformity and penile deformity, procedures to avoid inevitable shortening accompanying Nesbit's disease, and for penile lengthening.
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Affiliation(s)
- E S E Hafez
- Reproductive Health Center, Kiawah Island, South Carolina 29455, USA
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Corona G, Mannucci E, Petrone L, Giommi R, Mansani R, Fei L, Forti G, Maggi M. Psycho-biological correlates of hypoactive sexual desire in patients with erectile dysfunction. Int J Impot Res 2004; 16:275-81. [PMID: 14961059 DOI: 10.1038/sj.ijir.3901158] [Citation(s) in RCA: 75] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
We studied the psychological and biological correlates of hypoactive sexual desire (HSD) in a consecutive series of 428 patients with erectile dysfunction (ED), by using the structured interview SIEDY. A complete physical examination and a series of biochemical, hormonal, psychometric, and penile vascular tests were also performed. Among the patients studied, 22.8% reported a mild, 12.9% a moderate, and 4.6% a complete loss of sexual interest. Patients reporting HSD showed significantly lower testosterone (T) levels than the rest of the sample, although the prevalence of hypogonadism (T<10 nM) was comparable in the two groups. Only a minority (<2%) had severe hyperprolactinemia (>700 mU/l), which, nonetheless, was closely associated with a relevant HSD. Both mental disorders and use of medication interfering with sexual function were significantly associated with HSD, as well as depressive and anxiety symptoms. HSD patients showed significantly higher scores in SIEDY scale 2, which explores the relational component of ED. In particular, perceived partner's libido and climax were crucially associated with an impairment of patients' sexual desire. In conclusion, HSD in ED is associated with several biological, psychological, and relational factors that can be simultaneously identified and quantified using the SIEDY structured interview.
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Affiliation(s)
- G Corona
- Andrology Unit, Department of Clinical Physiopathology, University of Florence, Florence, Italy
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Abstract
OBJECTIVE To educate healthcare professionals on the historical aspects, clinical diagnosis, and current treatment methods of psychogenic erectile dysfunction. METHOD A topic review of current literature was performed. Chief sources included primarily mainstream journals in the fields of urology, psychiatry/psychology, impotence/erectile dysfunction, epidemiology, and internal medicine. MEDLINE and PsycINFO databases were utilized. DATA EXTRACTION Data from clinical studies, trials, and review articles concerned primarily with psychological aspects of the arousal (erectile function) phase of the male sexual response cycle were collected, analyzed, and summarized in this review article. RESULTS There has been a shift in how erectile dysfunction has been perceived and treated over the past 30 years. With the current focus now on the very prevalent organic causes of ED, psychological factors are increasingly overlooked, though they remain important to the treatment of the patient as a whole. This article provides a complete, concise review of the interplay between psychological components and erectile function, reviews the work-up and diagnosis of psychogenic ED, and discusses treatment methods. CONCLUSIONS Erectile dysfunction is a prevalent problem that can affect, and can be affected by, psychosocial aspects of a man's life. Medical or pharmacological interventions are often appropriate to treat ED, but the psychosocial aspects should not be ignored. It has become easier for practitioners to put aside patients' psychosocial and interpersonal concerns regarding sexual health. Clinicians provide the best possible treatment if they recognize that erectile dysfunction is a complex, multifactorial disorder, and treat accordingly.
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Kuan J, Brock G. Selective phosphodiesterase type 5 inhibition using tadalafil for the treatment of erectile dysfunction. Expert Opin Investig Drugs 2002; 11:1605-13. [PMID: 12437506 DOI: 10.1517/13543784.11.11.1605] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Erectile dysfunction (ED) pharmacotherapy has undergone dramatic advances over the past decade, since the introduction of phosphodiesterase type 5 inhibitors (PDE5). The availability of an oral agent, sildenafil, able to restore erectile function in the majority of men with an organic basis to their dysfunction, transformed the management. The numbers of men seeking medical attention for ED, along with the increased comfort of physicians treating it, has resulted in enhanced management of this condition. In spite of these advances, there exist a significant number of men who remain unsuccessfully treated with sildenafil. Development of new PDE5 inhibitors, with the promise of enhanced selectivity, longer duration of action, increased potency and greater ease of use are currently in the final stages of regulatory review in many countries. Tadalafil is the first such agent to gain preliminary EU approval and is reviewed in detail in this report. Focusing on its phase II/III trial results, tadalafil appears to have an enhanced period of responsiveness extending out to 36 hours in 60% of men using the 20 mg dose. Efficacy across a large population of men with ED of various causes (n = 1112) is in accordance with the other PDE5 inhibitors at 81%. Side effects are generally mild-to-moderate with study drop-out rate at 1.7% in the active arm compared to 1.1% among those receiving placebo. In summary, this agent will likely play an important role in the management of ED across a broad spectrum of aetiologies, once past the ongoing regulatory review process.
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Affiliation(s)
- James Kuan
- Dept. of Surgery, Division of Urology, St. Joseph's Health Centre, London, Ontario, Canada
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