1
|
Wang G, Li R, Feng C, Li K, Liu S, Fu Q. Galectin-3 is involved in inflammation and fibrosis in arteriogenic erectile dysfunction via the TLR4/MyD88/NF-κB pathway. Cell Death Discov 2024; 10:92. [PMID: 38378809 PMCID: PMC10879531 DOI: 10.1038/s41420-024-01859-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 02/04/2024] [Accepted: 02/08/2024] [Indexed: 02/22/2024] Open
Abstract
Galectin-3 (Gal-3) is a multifunctional protein that has been linked to fibrosis and inflammation in the cardiovascular system. In this study, we examined the impact of Gal-3 on inflammation and fibrosis in patients with arteriogenic erectile dysfunction (A-ED) and the underlying mechanisms involved. To induce arterial injury, we utilized cuffs on the periaqueductal common iliac arteries of Sprague‒Dawley (SD) rats and administered a high-fat diet to co-induce local atherosclerosis. Our results showed that we successfully developed a novel A-ED model that was validated based on histological evidence. In vivo, the vascular lumen of rats subjected to a high-fat diet and cuff placement exhibited significant narrowing, accompanied by the upregulation of Gal-3, Toll-like receptor 4 (TLR4), and myeloid differentiation primary response protein 88 (MyD88) expression in the penile cavernosa. This led to the activation of nuclear factor kappa B 65 (NF-κB-p65), resulting in reduced intracavernosal pressure, endothelial nitric oxide synthase expression, and smooth muscle content, promoting inflammation and fibrosis. However, treatment with Gal-3 inhibitor-modified citrus pectin (MCP) significantly normalized those effects. In vitro, knocking down Gal-3 led to a significant reduction in TLR4, MyD88, and NF-κB-p65 expression in corpus cavernosum smooth muscle cells (CCSMCs), decreasing inflammation levels. In conclusion, inhibiting Gal-3 may improve A-ED by reducing inflammation, endothelial injury, and fibrosis in the penile corpus cavernosum through the TLR4/MyD88/NF-κB pathway. These findings highlight the potential therapeutic target of Gal-3 in A-ED.
Collapse
Affiliation(s)
- Guanbo Wang
- Department of Urology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Ruiyu Li
- Department of Urology, Shandong Provincial Hospital, Shandong University, Jinan, China
| | - Chen Feng
- Department of Urology, Shandong Provincial Hospital, Shandong University, Jinan, China
| | - Kefan Li
- Department of Urology, Shandong Provincial Hospital, Shandong University, Jinan, China
| | - Shuai Liu
- Department of Urology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China.
- Department of Urology, Shandong Provincial Hospital, Shandong University, Jinan, China.
- Engineering Laboratory of Urinary Organ and Functional Reconstruction of Shandong Province, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China.
| | - Qiang Fu
- Department of Urology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China.
- Department of Urology, Shandong Provincial Hospital, Shandong University, Jinan, China.
- Engineering Laboratory of Urinary Organ and Functional Reconstruction of Shandong Province, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China.
| |
Collapse
|
2
|
Mohan V, Schönhofen J, Hoppe H, Schumacher M, Keo HH, Bechir M, Kalka C, Burkhard Rn M, Diehm N. Long-Term Outcomes of Drug-Eluting Stent Implantation for Patients With Atherosclerotic Erectile Dysfunction not Responding to PDE-5-Inhibitors. J Endovasc Ther 2023:15266028231183775. [PMID: 37365869 DOI: 10.1177/15266028231183775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2023]
Abstract
PURPOSE Endovascular therapy of erection-related arteries was shown to be a promising treatment option for patients with severe erectile dysfunction. Purpose of this study was to assess the longer-term safety and clinical success rate of endovascular revascularization of erection-related arteries with the Angiolite BTK stent in patients with arteriogenic erectile dysfunction. MATERIALS AND METHODS A total of 147 consecutive men (63.5±9.3 years) with erectile dysfunction due to 345 atherosclerotic lesions underwent endovascular revascularization. Patients received an International Index of Erectile Function (IIEF)-15 questionnaire at 30.3±7.2 months (follow-up [FU] period no less than 18 months) after stenting. An improvement by 4 points in the erectile function domain consisting of 6 questions (IIEF-6) was defined as minimal clinically important difference (MCID). RESULTS Technical success was achieved in 99% of lesions. One major adverse event occurred after endovascular revascularization. Sixty-eight (46%) patients completed their latest FU at least 18 months following the last intervention. Minimal clinically important difference was achieved in 54% (37/68) of patients. CONCLUSIONS In patients with arteriogenic erectile dysfunction not responding to phosphodiesterase-5-inhibitors (PDE-5-Is), endovascular therapy with a novel thin-strut sirolimus-eluting stent is a safe and effective treatment option during short- and longer-term FU. CLINICAL IMPACT Patients with severe erectile dysfunction profit greatly from endovascular therapy of erection-related arteries. Stable clinical outcomes are seen beyond a 1-year timeframe. It is proven that, the drug-eluting stent therapy for atherosclerotic ED in patients who have not responded to PDE-5-I therapy is safe and effective during longer-term follow-up.
Collapse
Affiliation(s)
- Vignes Mohan
- Vascular Institute Central Switzerland, Aarau, Switzerland
| | - Jan Schönhofen
- Department of Internal Medicine, Spitalzentrum Biel AG, Biel, Switzerland
| | - Hanno Hoppe
- SwissIntervention Microtherapy Center, Bern, Switzerland
- University of Bern, Bern, Switzerland
| | | | - Hak-Hong Keo
- Vascular Institute Central Switzerland, Aarau, Switzerland
| | - Markus Bechir
- Center for Internal Medicine, Hirslanden Clinic Aarau, Aarau, Switzerland
| | - Christoph Kalka
- Vascular Institute Central Switzerland, Aarau, Switzerland
- University of Bern, Bern, Switzerland
| | | | - Nicolas Diehm
- Vascular Institute Central Switzerland, Aarau, Switzerland
- University of Bern, Bern, Switzerland
- University of Applied Sciences Furtwangen, Villingen-Schwenningen, Germany
| |
Collapse
|
3
|
Bonanni M, Rehak L, Massaro G, Benedetto D, Matteucci A, Russo G, Esperto F, Federici M, Mauriello A, Sangiorgi GM. Autologous Immune Cell-Based Regenerative Therapies to Treat Vasculogenic Erectile Dysfunction: Is the Immuno-Centric Revolution Ready for the Prime Time? Biomedicines 2022; 10:biomedicines10051091. [PMID: 35625828 PMCID: PMC9138496 DOI: 10.3390/biomedicines10051091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 04/30/2022] [Accepted: 05/02/2022] [Indexed: 02/04/2023] Open
Abstract
About 35% of patients affected by erectile dysfunction (ED) do not respond to oral phosphodiesterase-5 inhibitors (PDE5i) and more severe vasculogenic refractory ED affects diabetic patients. Innovative approaches, such as regenerative therapies, including stem cell therapy (SCT) and platelet-rich plasma (PRP), are currently under investigation. Recent data point out that the regenerative capacity of stem cells is strongly influenced by local immune responses, with macrophages playing a pivotal role in the injury response and as a coordinator of tissue regeneration, suggesting that control of the immune response could be an appealing approach in regenerative medicine. A new generation of autologous cell therapy based on immune cells instead of stem cells, which could change regenerative medicine for good, is discussed. Increasing safety and efficacy data are coming from clinical trials using peripheral blood mononuclear cells to treat no-option critical limb ischemia and diabetic foot. In this review, ongoing phase 1/phase 2 stem cell clinical trials are discussed. In addition, we examine the mechanism of action and rationale, as well as propose a new generation of regenerative therapies, evolving from typical stem cell or growth factor to immune cell-based medicine, based on autologous peripheral blood mononuclear cells (PBMNC) concentrates for the treatment of ED.
Collapse
Affiliation(s)
- Michela Bonanni
- Department of Biomedicine and Prevention, Institute of Cardiology, University of Rome Tor Vergata, 00133 Rome, Italy; (M.B.); (G.M.); (D.B.); (A.M.); (G.R.)
| | - Laura Rehak
- Athena Biomedical Innovations, 50126 Florence, Italy;
| | - Gianluca Massaro
- Department of Biomedicine and Prevention, Institute of Cardiology, University of Rome Tor Vergata, 00133 Rome, Italy; (M.B.); (G.M.); (D.B.); (A.M.); (G.R.)
| | - Daniela Benedetto
- Department of Biomedicine and Prevention, Institute of Cardiology, University of Rome Tor Vergata, 00133 Rome, Italy; (M.B.); (G.M.); (D.B.); (A.M.); (G.R.)
| | - Andrea Matteucci
- Department of Biomedicine and Prevention, Institute of Cardiology, University of Rome Tor Vergata, 00133 Rome, Italy; (M.B.); (G.M.); (D.B.); (A.M.); (G.R.)
- Division of Cardiology San Filippo Neri Hospital, 00135 Rome, Italy
| | - Giulio Russo
- Department of Biomedicine and Prevention, Institute of Cardiology, University of Rome Tor Vergata, 00133 Rome, Italy; (M.B.); (G.M.); (D.B.); (A.M.); (G.R.)
| | | | - Massimo Federici
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy;
| | - Alessandro Mauriello
- Department of Experimental Medicine, University of Rome Tor Vergata, 00133 Rome, Italy;
| | - Giuseppe Massimo Sangiorgi
- Department of Biomedicine and Prevention, Institute of Cardiology, University of Rome Tor Vergata, 00133 Rome, Italy; (M.B.); (G.M.); (D.B.); (A.M.); (G.R.)
- Correspondence:
| |
Collapse
|
4
|
Anatomy, Pathophysiology, Molecular Mechanisms, and Clinical Management of Erectile Dysfunction in Patients Affected by Coronary Artery Disease: A Review. Biomedicines 2021; 9:biomedicines9040432. [PMID: 33923709 PMCID: PMC8074129 DOI: 10.3390/biomedicines9040432] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/06/2021] [Accepted: 04/13/2021] [Indexed: 12/17/2022] Open
Abstract
Erectile dysfunction (ED) has been defined as the inability to attain or maintain penile erection sufficient for successful sexual intercourse. ED carries a notable influence on life quality, with significant implications for family and social relationships. Because atherosclerosis of penile arteries represents one of the most frequent ED causes, patients presenting with it should always be investigated for potential coexistent coronary or peripheral disease. Up to 75% of ED patients have a stenosis of the iliac-pudendal-penile arteries, supplying the male genital organ’s perfusion. Recently, pathophysiology and molecular basis of male erection have been elucidated, giving the ground to pharmacological and mechanical revascularization treatment of this condition. This review will focus on the normal anatomy and physiology of erection, the pathophysiology of ED, the relation between ED and cardiovascular diseases, and, lastly, on the molecular basis of erectile dysfunction.
Collapse
|
5
|
Schönhofen J, Räber L, Knöchel J, Keo HH, Regli C, Kostal F, Schumacher MC, Sammarchi L, Bechir M, Diehm N. Endovascular Therapy for Arteriogenic Erectile Dysfunction With a Novel Sirolimus-Eluting Stent. J Sex Med 2021; 18:315-326. [PMID: 33454205 DOI: 10.1016/j.jsxm.2020.10.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 09/10/2020] [Accepted: 10/29/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Arteriogenic erectile dysfunction is a common disease oftentimes not satisfactory treatable with medical therapy. AIM To assess the safety and clinical success rate of endovascular revascularization of erection-related arteries with the angiolite BTK stent in patients with arteriogenic erectile dysfunction. METHODS A total of 100 consecutive men (61.8 ± 10 years) with atherosclerotic lesions in erection-related arteries agreed to participate and were included into a single-center all-comers registry. Endovascular therapy with angiolite BTK drug-eluting stents was performed on a total of 211 lesions. Patients received a baseline International Index of Erectile Function (IIEF)-15 questionnaire at first presentation and 3 and 12 months after stenting. An improvement by 4 points in the erectile function domain consisting of 6 questions (IIEF-6) was defined as minimal clinically important difference. A total of 24 patients with 52 stented arterial lesions underwent angiographic follow-up of the initially treated arterial side during secondary revascularization of the contralateral side (angiographic sub-study). OUTCOME Clinical improvement of erections in 100 patients undergoing endovascular revascularization of erection-related arteries. RESULTS No major adverse events occurred during endovascular revascularization or within 30 days thereafter. Technical success was achieved in all lesions and procedural success in all patients. At 1 year, 55 of 97 patients (56.7%) improved by at least 4 points in IIEF-6 score and thus achieved a clinically relevant improvement of erectile function.In the angiographic sub-study, arterial patency and binary restenosis were observed in 46 of 52 (88.5%) and in 8 of 52 (15.4%), respectively, after a mean follow-up of 9.6 ± 5.8 months. CLINICAL IMPLICATIONS In patients with arteriogenic erectile dysfunction, endovascular therapy with a novel thin-strut sirolimus eluting stent is a safe and feasible treatment option. STRENGTHS & LIMITATIONS This real-world arterial revascularization registry included patients with a multitude of risk factors for ED, thereby representing the heterogeneity in patients in the clinical practice, which is one of its strengths but also one of its weaknesses. Another strength was the focus being laid on analyzing outcomes of patients with arteriogenic ED using only a single endovascular device. Further studies are warranted to better define subgroups of patients with impaired clinical outcomes. CONCLUSION Within the present all-comers registry, endovascular therapy of erectile dysfunction with the angiolite BTK stent was shown to be a safe and feasible treatment option resulting in clinical improvement rates comparable to earlier clinical trials although also showing that further research is warranted to define patient subgroups with particular benefits of endovascular therapy. Schönhofen J, Räber L, Knöchel J, et al. Endovascular Therapy for Arteriogenic Erectile Dysfunction With a Novel Sirolimus-Eluting Stent. J Sex Med 2021;18:315-326.
Collapse
Affiliation(s)
- Jan Schönhofen
- Department of Angiolog, Vascular Institute Central Switzerland, Aarau, Switzerland
| | - Lorenz Räber
- Department of Cardiology, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Jonas Knöchel
- Department of Angiolog, Vascular Institute Central Switzerland, Aarau, Switzerland
| | - Hak Hong Keo
- Department of Angiolog, Vascular Institute Central Switzerland, Aarau, Switzerland
| | - Christian Regli
- Department of Angiolog, Vascular Institute Central Switzerland, Aarau, Switzerland
| | - Filip Kostal
- Department of Angiolog, Vascular Institute Central Switzerland, Aarau, Switzerland
| | | | - Lisa Sammarchi
- Department of Angiolog, Vascular Institute Central Switzerland, Aarau, Switzerland
| | - Markus Bechir
- Department of Internal Medicine, Hirslanden Clinic, Aarau, Switzerland
| | - Nicolas Diehm
- Department of Angiolog, Vascular Institute Central Switzerland, Aarau, Switzerland.
| |
Collapse
|
6
|
Sangiorgi G, Pizzuto A, Diehm N, Greco F, Fusco F, Chiricolo G, Vismara A, Altieri VM, Cereda A, Bongo S. Endovascular therapy for erectile dysfunction: current knowledge and future perspectives. Minerva Cardiol Angiol 2020; 69:579-595. [PMID: 32492987 DOI: 10.23736/s2724-5683.20.05136-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Erectile dysfunction (ED) is defined as the inability to attain or maintain penile erection sufficient for successful sexual intercourse. ED carries a notable influence on quality of life, with significant implications for family and social relationships. Because atherosclerosis of penile arteries represents one of the most frequent causes of ED, patients presenting with it should always be investigated for potential coexistent coronary or peripheral disease. Up to 75% of patients with ED have a stenosis of the iliac-pudendal-penile arteries, supplying perfusion of the male genital organ. Recently the potential treatment of this pathological condition by percutaneous approaches has emerged with good angiographic results and with a significant improvement in symptoms and quality of life. This review will focus on the normal anatomy and physiology of erection, the pathophysiology of ED, the relation between ED and cardiovascular diseases and, lastly, on new treatment modalities aimed at restoration of normal erectile function.
Collapse
Affiliation(s)
- Giuseppe Sangiorgi
- Department of Biomedicine and Prevention, Tor Vergata University of Rome, Rome, Italy -
| | - Alessandra Pizzuto
- Division of Cardiology, Department of Systemic Medicine, Tor Vergata University, Rome, Italy
| | - Nicolas Diehm
- Vascular Institute Central Switzerland, Aarau, Switzerland
| | | | - Ferdinando Fusco
- Department of Urology, Luigi Vanvitelli University, Caserta, Italy
| | - Gaetano Chiricolo
- Division of Cardiology, Department of Systemic Medicine, Tor Vergata University, Rome, Italy
| | - Alberto Vismara
- Department of Urology, Humanitas Gavazzeni Hospital, Bergamo, Italy
| | | | - Alberto Cereda
- Division of Cardiology, San Gaudenzio Clinic, Novara, Italy
| | - Sante Bongo
- Division of Cardiology, San Gaudenzio Clinic, Novara, Italy
| |
Collapse
|
7
|
Colson M, Cuzin B, Faix A, Grellet L, Huyghes É. Algorithmes de prise en charge du patient souffrant de dysfonction érectile. SEXOLOGIES 2018. [DOI: 10.1016/j.sexol.2018.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
8
|
Capogrosso P, Colicchia M, Ventimiglia E, Castagna G, Clementi MC, Suardi N, Castiglione F, Briganti A, Cantiello F, Damiano R, Montorsi F, Salonia A. One patient out of four with newly diagnosed erectile dysfunction is a young man--worrisome picture from the everyday clinical practice. J Sex Med 2013; 10:1833-41. [PMID: 23651423 DOI: 10.1111/jsm.12179] [Citation(s) in RCA: 82] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
INTRODUCTION Erectile dysfunction (ED) is a common complaint in men over 40 years of age, and prevalence rates increase throughout the aging period. Prevalence and risk factors of ED among young men have been scantly analyzed. AIM Assessing sociodemographic and clinical characteristics of young men (defined as ≤ 40 years) seeking first medical help for new onset ED as their primary sexual disorder. METHODS Complete sociodemographic and clinical data from 439 consecutive patients were analyzed. Health-significant comorbidities were scored with the Charlson Comorbidity Index (CCI). Patients completed the International Index of Erectile Function (IIEF). MAIN OUTCOME MEASURE Descriptive statistics tested sociodemographic and clinical differences between ED patients ≤ 40 years and >40 years. RESULTS New onset ED as the primary disorder was found in 114 (26%) men ≤ 40 years (mean [standard deviation [SD]] age: 32.4 [6.0]; range: 17-40 years). Patients ≤ 40 years had a lower rate of comorbid conditions (CCI = 0 in 90.4% vs. 58.3%; χ(2) , 39.12; P < 0.001), a lower mean body mass index value (P = 0.005), and a higher mean circulating total testosterone level (P = 0.005) as compared with those >40 years. Younger ED patients more frequently showed habit of cigarette smoking and use of illicit drug, as compared with older men (all P ≤ 0.02). Premature ejaculation was more comorbid in younger men, whereas Peyronie's disease was prevalent in the older group (all P = 0.03). At IIEF, severe ED rates were found in 48.8% younger men and 40% older men, respectively (P > 0.05). Similarly, rates of mild, mild-to-moderate, and moderate ED were not significantly different between the two groups. CONCLUSIONS This exploratory analysis showed that one in four patients seeking first medical help for new onset ED was younger than 40 years. Almost half of the young men suffered from severe ED, with comparable rates in older patients. Overall, younger men differed from older individuals in terms of both clinical and sociodemographic parameters.
Collapse
Affiliation(s)
- Paolo Capogrosso
- Department of Urology, University Vita-Salute San Raffaele, Milan, Italy
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
9
|
Hotaling JM, Waggott DR, Goldberg J, Jarvik G, Paterson AD, Cleary PA, Lachin J, Sarma A, Wessells H. Pilot genome-wide association search identifies potential loci for risk of erectile dysfunction in type 1 diabetes using the DCCT/EDIC study cohort. J Urol 2012; 188:514-20. [PMID: 22704111 PMCID: PMC3764461 DOI: 10.1016/j.juro.2012.04.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2011] [Indexed: 01/12/2023]
Abstract
PURPOSE We identified genetic predictors of diabetes associated erectile dysfunction using genome-wide and candidate gene approaches in a cohort of men with type 1 diabetes. MATERIALS AND METHODS We examined 528 white men with type 1 diabetes, including 125 with erectile dysfunction, from DCCT (Diabetes Control and Complications Trial) and its observational followup, the EDIC (Epidemiology of Diabetes Interventions and Complications) study. Erectile dysfunction was identified from a single International Index of Erectile Function item. A Human1M BeadChip (Illumina®) was used for genotyping. A total of 867,125 single nucleotide polymorphisms were subjected to analysis. Whole genome and candidate gene approaches were used to test the hypothesis that genetic polymorphisms may predispose men with type 1 diabetes to erectile dysfunction. Univariate and multivariate models were used, controlling for age, HbA1c, diabetes duration and prior randomization to intensive or conventional insulin therapy during DCCT. A stratified false discovery rate was used to perform the candidate gene approach. RESULTS Two single nucleotide polymorphisms located on chromosome 3 in 1 genomic loci were associated with erectile dysfunction with p <1 × 10(-6), including rs9810233 with p = 7 × 10(-7) and rs1920201 with p = 9 ×10(-7). The nearest gene to these 2 single nucleotide polymorphisms is ALCAM. Genetic association results at these loci were similar on univariate and multivariate analysis. No candidate genes met the criteria for statistical significance. CONCLUSIONS Two single nucleotide polymorphisms, rs9810233 and rs1920101, which are 25 kb apart, are associated with erectile dysfunction, although they do not meet the standard genome-wide association study significance criterion of p <5 × 10(-8). Other studies with larger sample sizes are required to determine whether ALCAM represents a novel gene in the pathogenesis of diabetes associated erectile dysfunction.
Collapse
Affiliation(s)
- James M. Hotaling
- Department of Urology, University of Washington School of Medicine,
Seattle, WA
| | - Daryl R. Waggott
- Samuel Lunenfeld Research Institute, Mount Sinai Hospital, Toronto,
CANADA
| | - Jack Goldberg
- Department of Epidemiology, University of Washington, Seattle,
WA
| | - Gail Jarvik
- Department of Medical Genetics, University of Washington School of
Medicine, Seattle, WA
| | - Andrew D. Paterson
- Dalla Lana School of Public Health, University of Toronto, Toronto,
CANADA
- Program in Genetics and Genomic Biology, Hospital for Sick Children,
Toronto, CANADA
| | - Patricia A Cleary
- George Washington University, The Biostatistics Center, Rockville,
MD
| | - John Lachin
- George Washington University, The Biostatistics Center, Rockville,
MD
| | - Aruna Sarma
- Department of Urology, University of Michigan, Ann Arbor, MI
| | - Hunter Wessells
- Department of Urology, University of Washington School of Medicine,
Seattle, WA
- Diabetes Research Center, University of Washington, Seattle WA
| | | |
Collapse
|
10
|
Hypogonadism in DM1 and its relationship to erectile dysfunction. J Neurol 2011; 258:1247-53. [PMID: 21344196 DOI: 10.1007/s00415-011-5914-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2010] [Revised: 01/10/2011] [Accepted: 01/11/2011] [Indexed: 10/18/2022]
Abstract
Myotonic dystrophy type 1 (DM1) is characterized by both a premature appearance of age-related phenotypes and multiple organ involvement, which affects skeletal and smooth muscle as well as the eye, heart, central nervous system, and endocrine system. Although erectile dysfunction (ED) is a frequent complaint in patients with DM1, it has not been investigated in great depth. Hypogonadism, which is reported to be one of the physical causes of ED in the general population, frequently occurs in DM1. We planned this case-control study to evaluate the relationship between hypogonadism, as defined by the sexual hormone profile (FSH, LH, testosterone (T) and prolactin) and ED, as assessed by means of an internationally validated self-administered questionnaire (IIEF). DM1 patients had significantly increased mean levels of both gonadotropins (FSH and LH) (p < 0.0001) and a reduced mean level of T (p < 0.0001) when compared to controls. Twelve patients were eugonadic (normal LH, T, and FSH), while 18 displayed hormonal evidence of hypogonadism, characterized by tubular failure (increased FSH) in all the subjects and associated with interstitial failure in 14 subjects: seven with primary hypogonadism (increased LH and reduced T) and seven with compensated hypogonadism (increased LH and normal T). Patients with hormonal evidence of interstitial failure had a larger CTG expansion (p = 0.008), longer disease duration (p = 0.013), higher grade of disease (p = 0.004) and lower erectile function score (p = 0.02) than eugonadic patients. Impotence occurred in 13/14 hypogonadic patients with interstitial failure and in 5/12 eugonadic patients (p = 0.017, OR = 18.2).
Collapse
|
11
|
Defining sexual function after radical retropubic prostatectomy. Urol Oncol 2010; 28:469-72. [DOI: 10.1016/j.urolonc.2010.01.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2010] [Accepted: 01/22/2010] [Indexed: 11/20/2022]
|
12
|
Liu CC, Huang SP, Wu WJ, Lee YC, Wang CJ. Management of Erectile Dysfunction With Hypogonadism. UROLOGICAL SCIENCE 2010. [DOI: 10.1016/s1879-5226(10)60025-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
13
|
Martins FG, Abdo CHN. Erectile Dysfunction and Correlated Factors in Brazilian Men Aged 18–40 years. J Sex Med 2010; 7:2166-2173. [DOI: 10.1111/j.1743-6109.2009.01542.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
|
14
|
Miner MM, Barnes A, Janning S. Efficacy of phosphodiesterase type 5 inhibitor treatment in men with erectile dysfunction and dyslipidemia: a post hoc analysis of the vardenafil statin study. J Sex Med 2010; 7:1937-47. [PMID: 20202105 DOI: 10.1111/j.1743-6109.2010.01766.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Dyslipidemia occurs often in subjects with erectile dysfunction (ED), but there is little information about how this condition affects ED treatment responses. AIM To determine whether low-density lipoprotein cholesterol (LDL-C) levels, total cholesterol (TC)/high-density lipoprotein cholesterol (HDL-C) ratio; or the presence of metabolic syndrome influenced efficacy of vardenafil in men with ED and dyslipidemia. METHODS Post hoc subgroup analysis of a 12-week study of the influence of lipid levels and presence of metabolic syndrome on the efficacy of vardenafil as measured by International Index of Erectile Function-Erectile Function (IIEF-EF) domain score, responses to Sexual Encounter Profile (SEP) SEP2 and SEP3 questions, duration of erection leading to successful intercourse, and erection duration regardless of the answer to SEP3. Lipid values were obtained at study start, after patients had received at least 3 months of therapy with a statin. MAIN OUTCOME MEASURES Outcomes in subjects with LDL-C < 100, > or = 100 to < 130, or > or = 130 mg/dL [< 2.59, > or = 2.59 to < 3.36, or > or = 3.36 mmol/L]; TC/HDL-C ratio < 3.5 vs. > or = 3.5, and presence or absence of metabolic syndrome. RESULTS Vardenafil improved all endpoints evaluated compared with placebo in all subgroups, however, nominally significant treatment by subgroup interaction terms did not follow a distinct pattern. Increasing LDL-C (P = 0.033), but not TC/HDL-C ratio or metabolic syndrome, was associated with an increase in treatment response measured by the IIEF-EF domain score. Responses to SEP3 were nominally influenced by LDL-C levels (P = 0.019), but were not significantly influenced by TC/HDL-C ratio, or the metabolic syndrome. Only higher TC/HDL-C ratios (> or = 3.5) were associated with larger treatment differences in duration of erection leading to successful intercourse (P = 0.028). CONCLUSIONS Vardenafil was effective in men with dyslipidemia regardless of LDL-C levels, TC/HDL-C ratio, and/or presence of metabolic syndrome. Despite the known presence of ED and dyslipidemia, other cardiovascular risk factors were apparently not aggressively managed.
Collapse
Affiliation(s)
- Martin M Miner
- Brown University School of Medicine, Providence, RI, USA.
| | | | | |
Collapse
|
15
|
Abdo CH, Afif-Abdo J, Otani F, Machado AC. Sexual Satisfaction among Patients with Erectile Dysfunction Treated with Counseling, Sildenafil, or Both. J Sex Med 2008; 5:1720-6. [DOI: 10.1111/j.1743-6109.2008.00841.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
|
16
|
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]
|
17
|
Aksoy S, Harputluoglu H, Kilickap S, Dincer M, Dizdar O, Akdogan B, Ozen H, Erman M, Celik I. Erectile dysfunction in successfully treated lymphoma patients. Support Care Cancer 2007; 16:291-7. [PMID: 17661093 DOI: 10.1007/s00520-007-0307-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2007] [Accepted: 06/21/2007] [Indexed: 10/23/2022]
Abstract
BACKGROUND Information on male potency in lymphoma survivors is insufficient. In this study, we assessed male sexual function and serum gonadotropins in successfully treated lymphoma patients. MATERIALS AND METHODS Fifty-nine patients treated for Hodgkin's lymphoma (HL) or non-HL (NHL) with chemotherapy +/- radiotherapy were included in the study. RESULTS The mean age (+/-standard deviation) of the patients was 40.2 +/- 11.0 (range, 18-55 years). Thirty-eight (64.4%) had HL and 21 (35.6%) NHL. According to the International Index of Erectile Function (IIEF) score, 61.0% had some degree of erectile dysfunction (ED; IIEF score < 26): 33.9% had mild ED (IIEF score 17-25), 15.2% moderate ED (IIEF score 11-16), and 11.9% severe ED (IIEF score 6-10). Age distribution was similar in patients with ED and those with normal erectile function. Presence of ED and its grade were not different between HL and NHL patients. Nine (18.4%) of 49 patients had an elevated follicle-stimulating hormone, 7 (14.2%) had elevated luteinizing hormone, and 3 (6.1%) had decreased testosterone levels. These hormonal abnormalities did not affect the presence of ED and its severity. CONCLUSIONS Overall, 61.0% of men in our study had ED according to IIEF. Clinicians should be aware of this problem in lymphoma survivors and offer these patients adequate treatment options.
Collapse
Affiliation(s)
- Sercan Aksoy
- Department of Medical Oncology, Institute of Oncology, Hacettepe University, Sihhiye, Ankara, Turkey.
| | | | | | | | | | | | | | | | | |
Collapse
|
18
|
Shabsigh R, Seftel AD, Rosen RC, Porst H, Ahuja S, Deeley MC, Garcia CS, Giuliano F. Review of time of onset and duration of clinical efficacy of phosphodiesterase type 5 inhibitors in treatment of erectile dysfunction. Urology 2006; 68:689-96. [PMID: 17070333 DOI: 10.1016/j.urology.2006.05.009] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2005] [Revised: 03/24/2006] [Accepted: 05/10/2006] [Indexed: 11/23/2022]
Affiliation(s)
- Ridwan Shabsigh
- Department of Urology, Columbia-Presbyterian Medical Center, New York, New York 10032, USA
| | | | | | | | | | | | | | | |
Collapse
|
19
|
Current World Literature. Curr Opin Urol 2005. [DOI: 10.1097/01.mou.0000188972.91538.be] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|