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Sakamoto F, Matsumoto S, Otani T, Takagi Y, Yamamoto T. The usefulness of shear wave elastography in evaluating erectile dysfunction severity before and after prostaglandin E1 test. Nagoya J Med Sci 2024; 86:104-109. [PMID: 38505715 PMCID: PMC10945220 DOI: 10.18999/nagjms.86.1.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 06/23/2023] [Indexed: 03/21/2024]
Abstract
Prostaglandin E1 intracavernous injection test is an established method for diagnosing erectile dysfunction. However, the evaluation is non-objective and often influenced by the evaluator's subjectivity. Herein, we measured and objectively evaluated shear wave elastography results of the corpus cavernosum before and after injection in 16 patients who underwent prostaglandin E1 testing. The response score of prostaglandin E1 tests were "1" in 2 cases, "2" in 2 cases, and "3" in 12 cases. The average transmission velocity before the injection and at the time of maximum erection after the injection were 2.21 m/s and 1.57 m/s, respectively. Transmission velocity decreased during erection in 14 of 16 cases (87.5%). The overall rate of change in transmission velocity due to injection was -26.7% and was significantly different between the poor (responses 1 and 2: -16.1%) and good erection (response 3: -30.2%) groups. To the best of our knowledge, this is the first attempt to evaluate erectile phenomenon using percutaneous ultrasonic elastography in Japan. Rate of change in shear wave transmission velocity due to prostaglandin E1 injection in the corpus cavernosum penis was associated with the degree of erection. Therefore, the rate of change in shear wave transmission velocity in the corpus cavernosum penis could be used as an objective index of erectile phenomenon. Percutaneous ultrasonic elastography is a non-invasive and useful test method for diagnosing erectile dysfunction, determining the therapeutic effect, and predicting prognosis.
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Affiliation(s)
| | - Seiji Matsumoto
- Headquarters for Research Promotion, Asahikawa Medical University, Asahikawa, Japan
- Clinical Research Support Center, Asahikawa Medical University Hospital, Asahikawa, Japan
| | - Toshikazu Otani
- Department of Urology, Chubu Rousai Hospital, Nagoya, Japan
- Department of Urology, Rokuwa Hospital, Inazawa, Japan
| | | | - Tokunori Yamamoto
- Clinical Research Support Center, Asahikawa Medical University Hospital, Asahikawa, Japan
- Promotion Office for Open Innovation, Institutes of Innovation for Future Society, Nagoya University, Nagoya, Japan
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Langarizadeh MA, Salary A, Tavakoli MR, Nejad BG, Fadaei S, Jahani Z, Forootanfar H. An overview of the history, current strategies, and potential future treatment approaches in erectile dysfunction: a comprehensive review. Sex Med Rev 2023:7131122. [PMID: 37076171 DOI: 10.1093/sxmrev/qead014] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 03/10/2023] [Accepted: 03/21/2023] [Indexed: 04/21/2023]
Abstract
INTRODUCTION Erectile dysfunction (ED) is one of the most common urologic problems in men worldwide, with an approximately high incidence rate, significantly affecting patients' quality of life and their sexual partners. OBJECTIVES Due to the association of this disorder with essential diseases such as cardiovascular disease and diabetes, its prevention and treatment are vital for overall human physiologic and psychological health. Along with reviewing the history of treatment and current methods, we seek new approaches to curb this issue in the future. METHODS In this review, investigations were based on the focus of each section's content or conducted on an ad hoc basis. Searches were performed in Scopus and PubMed. RESULTS In recent years, many treatments for ED have been reported besides oral administration of phosphodiesterase 5 inhibitors such as sildenafil and tadalafil (approved by the Food and Drug Administration). Common oral medications, intracavernous injections, herbal therapies (eg, herbal phosphodiesterase 5 inhibitors), and topical/transdermal medications are routine ED treatment approaches. Moreover, some novel medications are innovative candidates for completing ED's treatment protocols: stem cell injection, low-intensity extracorporeal shock wave therapy, platelet-rich plasma injection, gene therapy, amniotic fluid matrices, rho-kinase inhibitors, melanocortin receptor antagonists, maxi-K channel activators (ie, large-conductance calcium-activated potassium channels), guanylate cyclase activators, and nitric oxide donors. CONCLUSION Due to the importance of this complicated problem in men's society, a faster course of treatment trends toward new methods is needed to increase efficiency. Combining the mentioned treatments and attentively examining their efficacy through programmed clinical trials can be a big step toward solving this global problem.
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Affiliation(s)
- Mohammad Amin Langarizadeh
- Pharmaceutical Sciences and Cosmetic Products Research Center, Kerman University of Medical Sciences, Kerman 7616913555, Iran
| | - Amirhossein Salary
- Student Research Committee, Kerman University of Medical Sciences, Kerman 7616913555, Iran
| | | | - Behnam Ghorbani Nejad
- Department of Toxicology and Pharmacology, Faculty of Pharmacy, Kerman Medical University, Kerman 7616913555, Iran
| | - Shirin Fadaei
- Pharmaceutics Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman 7616913555, Iran
| | - Zahra Jahani
- Student Research Committee, Kerman University of Medical Sciences, Kerman 7616913555, Iran
| | - Hamid Forootanfar
- Pharmaceutical Sciences and Cosmetic Products Research Center, Kerman University of Medical Sciences, Kerman 7616913555, Iran
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Sng CMN, Wee LMC, Tang KC, Lee KCJ, Wu QH, Yeo JC, Bhagat AAS. Wearable Soft Microtube Sensors for Quantitative Home-Based Erectile Dysfunction Monitoring. Sensors (Basel) 2022; 22:9344. [PMID: 36502045 PMCID: PMC9738815 DOI: 10.3390/s22239344] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 11/18/2022] [Accepted: 11/23/2022] [Indexed: 06/17/2023]
Abstract
Quantifiable erectile dysfunction (ED) diagnosis involves the monitoring of rigidity and tumescence of the penile shaft during nocturnal penile tumescence (NPT). In this work, we introduce Erectile Dysfunction SENsor (EDSEN), a home-based wearable device for quantitative penile health monitoring based on stretchable microtubular sensing technology. Two types of sensors, the T- and R-sensors, are developed to effectively measure penile tumescence and rigidity, respectively. Conical models mimicking penile shaft were fabricated with polydimethylsiloxane (PDMS) material, using different base to curing agent ratios to replicate the different hardness properties of a penile shaft. A theoretical buckling force chart for the different penile models is generated to determine sufficiency criteria for sexual intercourse. An average erect penile length and circumference requires at least a Young's modulus of 179 kPa for optimal buckling force required for satisfactory sexual intercourse. The conical penile models were evaluated using EDSEN. Our results verified that the circumference of a penile shaft can be accurately measured by T-sensor and rigidity using the R-sensor. EDSEN provides a private and quantitative method to detect ED within the comfortable confines of the user's home.
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Affiliation(s)
- Chee Ming Noel Sng
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore 119276, Singapore
| | - Li Min Camillus Wee
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore 119276, Singapore
| | - Kum Cheong Tang
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore 119276, Singapore
| | - King Chien Joe Lee
- Department of Urology, National University Hospital, Singapore 119074, Singapore
| | - Qing Hui Wu
- Department of Urology, National University Hospital, Singapore 119074, Singapore
| | - Joo Chuan Yeo
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore 119276, Singapore
| | - Ali Asgar S. Bhagat
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore 119276, Singapore
- Department of Biomedical Engineering, National University of Singapore, Singapore 117583, Singapore
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Verze P, Belmonte M, Cai T, Otero JR. The penile ultrasound study: an unnecessary exam or an ace in the hole? Int J Impot Res 2022; 34:505-506. [PMID: 34584242 DOI: 10.1038/s41443-021-00473-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 09/02/2021] [Accepted: 09/13/2021] [Indexed: 02/04/2023]
Affiliation(s)
- Paolo Verze
- Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, Salerno, Italy.
| | - Mario Belmonte
- Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, Salerno, Italy
| | - Tommaso Cai
- Department of Urology, Santa Chiara Regional Hospital, Trento, Italy
| | - Javier Romero Otero
- Department of Urology, Instituto de Investigación Sanitaria Hospital 12 de October (imas12), Hospital Universitario 12 October, Madrid, Spain
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Simon V, Dudea SM, Crisan N, Stanca VD, Dudea-simon M, Andras I, Mihaly ZA, Coman I. Elastography in the Urological Practice: Urinary and Male Genital Tract, Prostate Excluded—Review. Diagnostics (Basel) 2022; 12:1727. [PMID: 35885631 PMCID: PMC9320571 DOI: 10.3390/diagnostics12071727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 07/08/2022] [Accepted: 07/12/2022] [Indexed: 11/16/2022] Open
Abstract
The aim of this article is to review the utility of elastography in the day-to-day clinical practice of the urologist. An electronic database search was performed on PubMed and Cochrane Library with a date range between January 2000 and December 2021. The search yielded 94 articles that passed the inclusion and exclusion criteria. The articles were reviewed and discussed by organ, pathology and according to the physical principle underlying the elastographic method. Elastography was used in the study of normal organs, tumoral masses, chronic upper and lower urinary tract obstructive diseases, dysfunctions of the lower urinary tract and the male reproductive system, and as a pre- and post-treatment monitoring tool. Elastography has numerous applications in urology, but due to a lack of standardization in the methodology and equipment, further studies are required.
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Aybar MD, Turna O. Assessment of the Rigidity Changes of Corpus Cavernosum Penis in Vasculary Erectile Dysfunction (ED) Subtypes by Shear Wave Elastography (SWE). J Ultrasound Med 2022; 41:629-636. [PMID: 33945173 DOI: 10.1002/jum.15741] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Erectile dysfunction (ED) is a condition that is very common all over the world, concerns about men and causes very important social problems. The aim of this study is to perform quantitative penile corpus cavernosum (CC) stiffness measurements by using SWE for patients with both types of vascular ED. METHODS In our study, we handled the data of 101 participants in total. The average age of the participants was 56.36. We divided the participants after color Doppler US (CDUS) into three groups: normal group (n = 30), arterial insufficiency (n = 51), and venous insufficiency (n = 20). SWE measurements were made in both groups in the CC flaccid (f) and rigid (r) positions, and the results were noted. International Index of Erectile Function (IIEF-5) questionnaire and Erection score (ES) were evaluated. RESULTS The mean CC f SWE and r SWE measurement values were 20.2 ± 0.8 and 17.15 ± 0.54 kPa, 3.84 ± 0.13 and 2.78 ± 0.11 m/s in the arterial insufficiency group; 15.72 ± 0.58 and 12.52 ± 0.33 kPa, 2.88 ± 0.06 and 2.09 ± 0.11 m/s in the venous insufficiency group; 14.75 ± 0.51 and 13.41 ± 0.36 kPa, 2.63 ± 0.1 and 2.34 ± 0.11 m/s in the control group, respectively. The CC measurement of f SWE and r SWE values as kPa showed significant differences between the groups (P < .001). CONCLUSION SWE can provide quantitative data with high specificity and sensitivity while evaluating CC penile stiffness noninvasively. It seems to contribute to the radiological evaluation of ED cases with useful data.
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Affiliation(s)
| | - Onder Turna
- Radiology Department, Mehmet Akif Ersoy Training and Research Hospital, Istanbul, Turkey
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Abdelwahab KM, Eldery MS, Desoky E, El-Babouly IM, Taha K, Saber S, Seleem MM. Role of shear wave elastography (SWE) in erectile dysfunction patients for evaluation of daily tadalafil treatment outcome. Andrologia 2022; 54:e14359. [PMID: 35019157 DOI: 10.1111/and.14359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 12/16/2021] [Accepted: 12/18/2021] [Indexed: 11/26/2022] Open
Abstract
The purpose of this study was to evaluate and anticipate the outcome of daily use of tadalafil in patients with erectile dysfunction using elastography. 183 volunteers and 183 patients with erectile dysfunction were included. Pretreatment SWE readings for our patients were calculated with a linear probe. IIEF score Q was measured once at the start of the study for volunteers and twice for patients, one prior to the start of tadalafil administration and the other on one year of 5 mg daily tadalafil after the second post-washout (one month post-treatment stopped). There was no significant difference between patients and volunteers in mean age or risk factors except in SWE values as mean SWE of volunteers was 14.03 ± 1.54 kpasc, while mean SWE of patients was 21.278 ± 8.228 kpasc. The presence of comorbid diabetes, severe disease and pre-SWE ≥23.635 was significantly associated with poor outcome. We conclude that penile SWE could be useful to select probable good responders for a continuous tadalafil use, thus avoiding the unnecessary cost and time in non-responders.
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Affiliation(s)
| | | | - Esam Desoky
- Urology Department, Zagazig University, Zagazig, Egypt
| | | | - Kareem Taha
- Radiodiagnosis Department, Zagazig University, Zagazig, Egypt
| | - Sameh Saber
- Radiodiagnosis Department, Zagazig University, Zagazig, Egypt
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Zhang Y, Zhou W, Wu X, Zhao S, Zhang X. Role of shear wave elastography measured in the flaccid state in predicting arteriogenic erectile dysfunction. Andrologia 2021; 53:e13996. [PMID: 33527468 DOI: 10.1111/and.13996] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 01/05/2021] [Accepted: 01/14/2021] [Indexed: 12/23/2022] Open
Abstract
The gold-standard method for diagnosing arteriogenic erectile dysfunction (AED) is the penile Doppler ultrasonography. We proposed a novel method for predicting AED using ultrasonic shear wave elastography (SWE) considering that the former was invasive and variable. A total of 98 male patients were enrolled in our study, referred for ED between December 2018 and October 2020. For comparison, we also included 42 volunteers from the Healthy Physical Examination Center of our hospital. The Penile Doppler Ultrasonography (PDU) and SWE were performed for all patients with the intracavernosal injection (ICI). We named three groups as AED group, nonvascular ED group and healthy controls group. No statistically significant differences were found among the three groups in terms of demographic and clinical characteristics. There were no significant differences in IIEF-5 between AED and nonvascular ED. A significant (r = 0.642, p < 0.0001) positive correlation between flaccid and erectile SWE was observed. With a cut-off value of 13.45 KPa, the area under curve, specificity, and sensitivity of the SWE values under the flaccid state in distinguishing AED from healthy subjects were 0.867, 0.786 and 0.896 respectively. The SWE value in the flaccid state can distinguish the AED from healthy subjects.
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Affiliation(s)
- Yuyang Zhang
- The Department of Urology, The First Affiliated Hospital of Anhui Medical University, Anhui Province, China
| | - Wang Zhou
- The Department of Ultrasound, The First Affiliated Hospital of Anhui Medical University, Anhui province, China
| | - Xu Wu
- The Department of Urology, The First Affiliated Hospital of Anhui Medical University, Anhui Province, China
| | - Sheng Zhao
- The Department of Ultrasound, The First Affiliated Hospital of Anhui Medical University, Anhui province, China
| | - Xiansheng Zhang
- The Department of Urology, The First Affiliated Hospital of Anhui Medical University, Anhui Province, China
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