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Canguven O, Khalafalla K, Al Ansari A. Low-intensity extracorporeal shockwave therapy for erectile dysfunction. Arab J Urol 2021; 19:340-345. [PMID: 34552784 PMCID: PMC8451630 DOI: 10.1080/2090598x.2021.1948158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 03/05/2021] [Indexed: 11/20/2022] Open
Abstract
Objectives: To review the current evidence of clinical effectiveness of low-intensity extracorporeal shockwave therapy (LI-ESWT) treatment for erectile dysfunction (ED). METHODS A selective database search using Medical Subject Headings (MeSH) terms 'low intensity extracorporeal shock wave therapy' and 'erectile dysfunction' was conducted in accordance with the Preferred Reporting Items for Systemic Reviews and Meta Analyses (PRISMA) guidelines to review the effectiveness of LI-ESWT for ED. We performed a systematic search of publications using the PubMed and Web of Science databases (January 2010-December 2020) for prospective randomised clinical trials (RCTs). The success rate of LI-ESWT associated with ED were recorded and analysed. RESULTS A total of 106 articles were reviewed after searching for the keywords. Overall, 11 RCTs were included in this systematic review. A total of 920 male patients were treated in 11 RCTs. The patients' ages ranged from 18 to 80 years and they had ≥3 months of ED symptoms. Vasculogenic and neurogenic causes were addressed in 81% and 19% of patients, respectively. Of the 920 patients, 348 patients had a statistically significant improvement in their erectile function after LI-ESWT; however, 572 did not have a statistically significant improvement. CONCLUSIONS The present review found that LI-ESWT has a role in ED treatment in laboratory studies, but its role in human clinical trials is still controversial. Further good quality studies need to be conducted to properly assess its true potential in ED treatment.
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Talib R, Alnadhari I, Canguven O, Yassin A, Shamsodini A, Alrumaihi K, Al-Ansari A. HbA1c over 8.5% is not predictive of increased infection rate following penile prosthesis implant surgery in diabetic patients with erectile dysfunction. Andrologia 2021; 53:e14132. [PMID: 34062008 DOI: 10.1111/and.14132] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 05/12/2021] [Accepted: 05/14/2021] [Indexed: 11/29/2022] Open
Abstract
Diabetes mellitus is associated with increased risk of erectile dysfunction. Penile prosthesis implantation is an efficient therapeutic option for erectile dysfunction, but not without risk, as infection remains a prominent concern. This study investigates diabetes mellitus as a risk factor for penile prosthesis implantation infection and the relationship between haemoglobinA1c levels and infection rates. All diabetic patients with erectile dysfunction who underwent penile prosthesis implantation surgery between January 2012 and November 2019 at Hamad Medical Corporation, Qatar, were included in this retrospective observational study. A total of 599 diabetic patients with erectile dysfunction had penile prosthesis implantation. Mean age was 59.69 ± 31.19. Penile prosthesis implantation infection rate was 0.83% (5/599), while the mean haemoglobinA1c level was 7.58 ± 1.45 mmol/l (range: 4.1-12.6). A comparison between diabetic patients with penile prosthesis implantation infection and those without infection revealed no significant difference in the level of haemoglobinA1c between the two groups with mean haemoglobinA1c in patients with infected implants 7.14 and 7.59 for noninfected (p = 0.491). Limitations include retrospective single-centre design and low-infection rates reducing sample number. Penile prosthesis implantation infection rate in a large series of diabetic patients was low with no significant association between haemoglobinA1c level and penile prosthesis implantation infection observed.
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Affiliation(s)
- Raidh Talib
- Department of Urology, Andrology Unit, Hamad medical corporation, Doha, Qatar.,Weill Cornel Medical School (WCM-Q), Doha, Qatar
| | - Ibrahim Alnadhari
- Department of Urology, Andrology Unit, Hamad medical corporation, Doha, Qatar
| | - Onder Canguven
- Department of Urology, Andrology Unit, Hamad medical corporation, Doha, Qatar.,Weill Cornel Medical School (WCM-Q), Doha, Qatar
| | - Aksam Yassin
- Department of Urology, Andrology Unit, Hamad medical corporation, Doha, Qatar.,Weill Cornel Medical School (WCM-Q), Doha, Qatar.,Center of Medicine and Health Sciences, Dresden International University, Dresden, Germany
| | - Ahmad Shamsodini
- Department of Urology, Andrology Unit, Hamad medical corporation, Doha, Qatar.,Weill Cornel Medical School (WCM-Q), Doha, Qatar
| | - Khalid Alrumaihi
- Department of Urology, Andrology Unit, Hamad medical corporation, Doha, Qatar.,Weill Cornel Medical School (WCM-Q), Doha, Qatar.,Center of Medicine and Health Sciences, Dresden International University, Dresden, Germany
| | - Abdulla Al-Ansari
- Department of Urology, Andrology Unit, Hamad medical corporation, Doha, Qatar.,Weill Cornel Medical School (WCM-Q), Doha, Qatar
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3
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Saeed R, Amin F, Durrani N, Saif SMA, Zafar MT. Prevalence of erectile dysfunction and associated factors among males visiting family medicine clinics in a Tertiary Care Hospital in Karachi, Pakistan. J Family Med Prim Care 2021; 10:1294-1300. [PMID: 34041168 PMCID: PMC8140281 DOI: 10.4103/jfmpc.jfmpc_1871_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 10/24/2020] [Accepted: 12/20/2020] [Indexed: 11/04/2022] Open
Abstract
Background The burden of erectile dysfunction (ED) among the developed countries is found to be quite high. However, there is a paucity of data among developing countries to know its actual burden and factors associated with it. Methods The current study is cross-sectional and was conducted in Family Medicine clinics of Liaquat National Hospital during May 2017-January 2018. A total of 450 males participated in this study with the age range of 24-77 years. More than half of the participants were graduates or above. Results On multivariable analysis, age (aOR = 5.47, 95% CI: 2.74-10.89), alcohol use (aOR = 5.23, 95% CI: 1.45-18.84), diabetes (aOR = 6.61, 95% CI: 3.27-13.36), and current smoking (OR = 2.41, 95% CI: 1.35-4.31) were significantly associated with ED. ED risk was significantly lower in those who either attended secondary school (aOR = 0.33, 95% CI: 0.13-0.88) or were at least graduates (aOR = 0.40, 95% CI: 0.17-0.96) than illiterate when model was adjusted for other covariates. Conclusion Erectile dysfunction in a Pakistani male population highlights the need for routine screening at the primary care level. There is a possibility that the actual burden is underreported due to cultural stigmatization; hence, further research is warranted to validate the findings.
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Affiliation(s)
- Rabeeya Saeed
- Assistant Professor, Liaquat National Hospital and Medical College, Karachi, Pakistan
| | - Faridah Amin
- Associate Professor, Department of Family Medicine, Liaquat National Hospital and Medical College, Karachi, Pakistan
| | - Noureen Durrani
- Biostatistician, Department of Publication, Liaquat National Hospital and Medical College, Karachi, Pakistan
| | - Syed M Ali Saif
- Intern, Liaquat National Hospital and Medical College, Karachi, Pakistan
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4
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Kamal EE, Ali MEM, Mohamed MZ, Soliman M, El-Mahdy RI, Elsayed A, Badran AY. Relation of pharmacopenile duplex ultrasonography parameters and glycated hemoglobin (HbA1c) in diabetic patients with erectile dysfunction. Rev Int Androl 2020; 20:31-40. [PMID: 33334711 DOI: 10.1016/j.androl.2020.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 04/22/2020] [Accepted: 05/26/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION AND OBJECTIVES Erectile dysfunction (ED) is one of the main threats in diabetic patients. This research aimed to assess the relationship between glycated hemoglobin (HbA1c) level and pharmacopenile duplex ultrasonography (PPDU) indices in diabetic patients with ED. MATERIALS AND METHODS A total of 130 males with ED were recruited (100 had diabetes mellitus (DM) and 30 did not as control). The International Index of Erectile Function (IIEF) was used to evaluate patients for ED. Measurement of HbA1c, lipid profile and assessment of erectile function using PPDU were performed. All participants were assessed to take the medical history. RESULTS The mean age±SD was 53.8±8.9 and 53.6±2.8 years for patients and controls, respectively. Patients had variable grades of ED: mild in 20%, mild to moderate in 32.3%, moderate in 35.3%, and severe in 12.3%. A significant association was found between the existence of DM and a deprived response to intracorporeal injection (ICI), rising end-diastolic velocity (EDV), and reducing resistance index (RI) values. Comparing all diabetic groups according to HbA1c with controls, a significant relationship was found in; severity of IIEF-5 score, poor response to ICI, decreased peak systolic velocity (PSV) at 10min, increased EDV at 10, 20min and decreased RI at 10, 20min. A significant relationship was found between smoking, dyslipidaemia, and decreased PSV at 10, 20min and decreased increment ratio. However, a non-significant relationship was observed between age, type of DM and PPDU parameters. CONCLUSION Poor glycaemic control of DM is associated with an increase in EDV and decrease in RI, and PSV of PPDU.
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Affiliation(s)
- Emad Eldien Kamal
- Department of Dermatology and Andrology, Faculty of Medicine, Assiut University, Egypt
| | - Mohammed Essam M Ali
- Department of Dermatology and Andrology, Faculty of Medicine, Assiut University, Egypt
| | | | - Mona Soliman
- Department of Internal medicine and endocrinology, Faculty of Medicine, Assiut University, Egypt
| | - Reham I El-Mahdy
- Department of Medical Biochemistry, Faculty of Medicine, Assiut University, Egypt.
| | - Ahmed Elsayed
- Department of Dermatology and Andrology, Faculty of Medicine, Assiut University, Egypt
| | - Aya Y Badran
- Department of Dermatology and Andrology, Faculty of Medicine, Assiut University, Egypt
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5
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Pizzol D, Smith L, Fontana L, Caruso MG, Bertoldo A, Demurtas J, McDermott D, Garolla A, Grabovac I, Veronese N. Associations between body mass index, waist circumference and erectile dysfunction: a systematic review and META-analysis. Rev Endocr Metab Disord 2020; 21:657-666. [PMID: 32002782 DOI: 10.1007/s11154-020-09541-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Growing evidence reports that obesity might play a role in erectile dysfunction (ED), but limited knowledge is available. We conducted a meta-analysis to estimate the prevalence of ED in overweight men and men with obesity. We performed a systematic review up to 01/04/2019 to investigate the associations between obesity and ED. Applying a random-effect model, we calculated the prevalence of ED, the odds ratio (OR) for the presence of ED by Body Mass Index (BMI) categories and the mean differences between ED and controls in BMI and Waist Circumference (WC). Among 3409 studies, we included 45 articles with 42,489 men (mean age = 55 years). Taking normal weight men as reference, the prevalence of ED was significantly higher in overweight (OR = 1.31; 95%CI: 1.13-1.51; I2 = 72%) and in men with obesity (OR = 1.60; 95%CI: 1.29-1.98; I2 = 79%). Adjusting our analyses for potential confounders, the results were confirmed in men with obesity (OR = 1.46; 95%CI: 1.24-1.72; I2 = 72%). ED was associated with significant higher values of BMI (MD = 0.769; 95%CI: 0.565-0.973 Kg/m2; I2 = 78%) and WC (MD = 5.251 cm; 95%CI: 1.295-9.208; I2 = 96%). Considering the high prevalence of ED among men with obesity, clinicians should screen for this clinical condition in this population. Findings from the present study suggest that reducing adiposity is a crucial approach in patients with ED who are affected by obesity.
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Affiliation(s)
- Damiano Pizzol
- Italian Agency for Development Cooperation, Jerusalem, Israel
| | - Lee Smith
- The Cambridge Centre for Sport & Exercise Sciences, Anglia Ruskin University, Cambridge, UK
| | - Luigi Fontana
- Faculty of Medicine and Health and Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Maria Gabriella Caruso
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology, Research Hospital, IRCCS "Saverio de Bellis" of Castellana Grotte (BA), 70013, Castellana Grotte, Italy
| | | | - Jacopo Demurtas
- Primary Care Department Azienda USL Toscana Sud Est, Grosseto, Italy
| | - Daragh McDermott
- The Cambridge Centre for Sport & Exercise Sciences, Anglia Ruskin University, Cambridge, UK
| | - Andrea Garolla
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, Padova, Italy
| | - Igor Grabovac
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Vienna, Austria
| | - Nicola Veronese
- National Research Council, Neuroscience Institute, Aging Branch, 35128, Padova, Italy.
- Primary Care Department, Geriatric Unit, Azienda ULSS (Unità Locale Socio Sanitaria) 3 "Serenissima", Dolo-Mirano District, Milano, Italy.
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Zauner G, Girardi G. Potential causes of male and female infertility in Qatar. J Reprod Immunol 2020; 141:103173. [PMID: 32652349 DOI: 10.1016/j.jri.2020.103173] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 06/14/2020] [Accepted: 06/22/2020] [Indexed: 12/13/2022]
Abstract
A steady decline in the fertility rate has been observed in Qatar during the past fifty years. Therefore, infertility is considered a national priority in Qatar, a pronatalist society. This review article summarises the potential causes of infertility that are particularly prevalent in the Qatari population. The high rate of consanguinity leading to genetic abnormalities, the high incidence of metabolic disease, environmental contamination due to the rapid urbanization and oil and natural gas extraction procedures are discussed. In addition, the particular lifestyle of the Qatari population and the influence of religion and culture on sexual and reproductive behavior in an Arab/Islamic society are considered. The active response of the state of Qatar in implementing ways to mitigate the effects of these factors to protect fertility are also presented.
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Affiliation(s)
- Gerhild Zauner
- Department of Basic Medical Sciences, College of Medicine, Member of QU Health, Qatar University, Doha, Qatar
| | - Guillermina Girardi
- Department of Basic Medical Sciences, College of Medicine, Member of QU Health, Qatar University, Doha, Qatar.
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Tridiantari DK, Saraswati LD, Udiyono A. Epidemiology of erectile dysfunction in men with diabetes mellitus: a study in a primary health care center in Indonesia. MEDICAL JOURNAL OF INDONESIA 2020. [DOI: 10.13181/mji.oa.192070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
BACKGROUND Diabetes mellitus (DM) is one of the factors causing erectile dysfunction (ED) and may affect a person's quality of life. This study was aimed to describe the epidemiology of ED in men with DM in a primary health care.
METHODS The study used a cross-sectional study design conducted from January to March 2017 at the Tlogosari Kulon Health Center, Semarang. There were 122 diabetic men who were all included in the study. The data were collected using interviewerassisted questionnaires. The status of ED was measured by the erectile dysfunction intensity scale adapted to the International Index of Erectile Function.
RESULTS The results showed that the prevalence of diabetic men with ED was 84.4%. Most men with ED had age of ≥46 years (91.0%), experienced work stress (88.5%), had low physical activity (93.1%), had obesity (88.0%) of which 86.3% had central obesity, smoking (84.6%), had DM >5 years (91.2%), and took antihypertensive drugs (90.0%). The fasting blood glucose level of respondents ≥126 mg/dl was 86.0%, and 91.7% had sexual desire disorder. The duration of DM and aging are contributing factors of ED in males with DM, with a p-value of 0.016 and 0.013, respectively.
CONCLUSIONS The prevalence of ED in primary health care is still high, and the determining factors were the duration of DM and aging. Public health centers are advised to undertake health promotion on the prevention of factors that can lead to sexual dysfunction in males with DM.
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Song WH, Park J, Yoo S, Oh S, Cho SY, Cho MC, Jeong H, Son H. Changes in the Prevalence and Risk Factors of Erectile Dysfunction during a Decade: The Korean Internet Sexuality Survey (KISS), a 10-Year-Interval Web-Based Survey. World J Mens Health 2018; 37:199-209. [PMID: 30588782 PMCID: PMC6479078 DOI: 10.5534/wjmh.180054] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Revised: 09/15/2018] [Accepted: 09/17/2018] [Indexed: 01/23/2023] Open
Abstract
Purpose Although the prevalence of erectile dysfunction (ED) can be affected by social changes, this association has not been well evaluated. We aimed to evaluate the prevalence and risk factors of ED through a 10-year-interval web-based survey using the previous database of same group of panels, with same methodology. Materials and Methods We sent e-mails and surveyed the panels registered in the Internet survey agency. Results In total, 900 participants were recruited in 2016. The age-adjusted overall prevalences of self-reported ED (self-ED) and International Index of Erectile Function-5-assessed ED (IIEF-5-ED; score ≤21) in the 2016 study were 3.2% and 44.8%, respectively, which were lower than the prevalences of 8.1% (p=0.036) and 51.4% (p=0.323), respectively, in the 2006 study. The risk factors of IIEF-5-ED in their 20s and 30s in 2016 were psycho-social factors such as depression, low frequency of conversation about sex with sexual partner. The risk factors of IIEF-5-ED in their 40s to 60s in 2016 were organic factors, such as hypertension, diabetes mellitus, smoking, alcohol use, and self-reported premature ejaculation. Conclusions Although the age-adjusted overall prevalence of self-ED has decreased during a decade, there was no difference in the age-adjusted overall prevalence of IIEF-5-ED. Psycho-social support may be important for young men with ED and overall healthcare can be helpful for elderly men with ED.
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Affiliation(s)
- Won Hoon Song
- Department of Urology, Seoul National University College of Medicine, Seoul, Korea
| | - Juhyun Park
- Department of Urology, Seoul National University College of Medicine, Seoul, Korea.,Department of Urology, SMG-SNU Boramae Medical Center, Seoul, Korea
| | - Sangjun Yoo
- Department of Urology, SMG-SNU Boramae Medical Center, Seoul, Korea
| | - Sohee Oh
- Department of Biostatistics, SMG-SNU Boramae Medical Center, Seoul, Korea
| | - Sung Yong Cho
- Department of Urology, SMG-SNU Boramae Medical Center, Seoul, Korea
| | - Min Chul Cho
- Department of Urology, SMG-SNU Boramae Medical Center, Seoul, Korea
| | - Hyeon Jeong
- Department of Urology, Seoul National University College of Medicine, Seoul, Korea.,Department of Urology, SMG-SNU Boramae Medical Center, Seoul, Korea
| | - Hwancheol Son
- Department of Urology, Seoul National University College of Medicine, Seoul, Korea.,Department of Urology, SMG-SNU Boramae Medical Center, Seoul, Korea.
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9
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Wang XY, Huang W, Zhang Y. Relation between hypertension and erectile dysfunction: a meta-analysisof cross-section studies. Int J Impot Res 2018; 30:141-146. [DOI: 10.1038/s41443-018-0020-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Revised: 06/27/2017] [Accepted: 07/14/2017] [Indexed: 02/02/2023]
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Canguven O, Talib R, El Ansari W, Khalafalla K, Al Ansari A. Is Hba1c level of diabetic patients associated with penile prosthesis implantation infections? Aging Male 2018; 22:1-6. [PMID: 29523037 DOI: 10.1080/13685538.2018.1448059] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 02/28/2018] [Indexed: 10/17/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Diabetes mellitus is an important risk factor for erectile dysfunction (ED). Penile prosthesis implantation surgery is the final solution for diabetic patients with ED, but infections thereof are still a serious risk factor. While some studies suggest that most infections associated with penile prosthesis implantation are associated to high glycated hemoglobin (HbA1c) levels, other research did support such relationship. MATERIALS AND METHODS The current study assessed retrospectively, the association between HbA1c level and penile prosthesis surgery infection. We retrieved and reviewed the records of 300 diabetic patients who had penile prosthesis surgery at our Institution (January 2012-November 2016). Patients' mean age was 55.26 ± 10.9 years (31% patients were <50 years of age), and mean HbA1c was 7.60 ± 1.90%. RESULTS Infection rate among diabetics was 0.67%. Prevalence of prosthesis infection among patients with HbA1c ≤ 9% was 0.9%, compared with 0% among patients with HbA1c > 9%. Prosthesis infection risk did not significantly increase with higher HbA1c levels, with no meaningful difference in the median or mean level of HbA1c in the infected and non-infected diabetic patients. CONCLUSION Findings do not support the use of HbA1c values among diabetic patients who are candidates for penile prosthesis implantation surgery in order to identify and exclude those who might be prone to increased risk of prosthesis infections. Future studies would benefit from larger sample sizes in order to support or refute our findings.
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Affiliation(s)
| | - Raidh Talib
- b Department of Urology & Andrology , Hamad General Hospital , Doha , Qatar
| | - Walid El Ansari
- c Department of Surgery , Hamad General Hospital , Doha , Qatar
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11
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Canguven O, Talib RA, El-Ansari W, Shamsoddini A, Salman M, Al-Ansari A. RigiScan data under long-term testosterone therapy: improving long-term blood circulation of penile arteries, penile length and girth, erectile function, and nocturnal penile tumescence and duration. Aging Male 2016; 19:215-220. [PMID: 27690744 DOI: 10.1080/13685538.2016.1230602] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND Late-onset hypogonadism (LOH) presents with low serum testosterone (TT) levels and sexual and nonsexual symptoms. Erectile dysfunction affects a man's self-esteem and as a result partner relationship and quality of life. OBJECTIVES To investigate the andrological clinical profile outcomes of testosterone therapy (TTh) in men (n = 88) with symptomatic LOH complaints and symptoms. MAIN OUTCOME MEASURES Erectile function was assessed using the International Index of Erectile Function-5 questionnaire at baseline and at 6 and 12 months of TTh. In addition, penile length was measured at baseline and 12 months. We also evaluated nocturnal penile tumescence (NPT, using RigiScan) and blood flow of cavernous arteries (penile Doppler ultrasonography) at baseline and 12 months of TT. MATERIALS AND METHODS Eighty-eight LOH men (Mage 51.1 years) with erectile dysfunction, all with serum TT <10.4 nmol/L before TTh. Patients received intramuscular long-acting testosterone undecanoate for 12 months. RESULTS Following TTh, in all patients, serum TT levels were restored within 3 months to normal levels. Compared with baseline values, erectile function significantly improved at 6 (mean score increase 1.95) and 12 months (mean score increase 2.16). No significant changes in penile length were observed. NPT significantly improved at 12 months in terms of both the frequency (mean increase 1.27 times) and duration of rigidity (mean increase 5.12 min). As regards the blood flow of the cavernous arteries, we observed a significant improvement (decrease of 1.16 cm/s) and end diastolic velocity of the penile arteries. CONCLUSION TTh in men with LOH resulted in improvement of the erectile function, NPT, and to some extent the blood flow of the cavernous arteries.
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Affiliation(s)
- Onder Canguven
- a Department of Urology , Hamad Medical Corporation , Doha , Qatar
- b Weill Cornell Medical College in Qatar , Doha , Qatar
| | - Raidh A Talib
- a Department of Urology , Hamad Medical Corporation , Doha , Qatar
- b Weill Cornell Medical College in Qatar , Doha , Qatar
| | - Walid El-Ansari
- c Department of Surgery , Hamad Medical Corporation , Doha , Qatar
| | | | - Mahmoud Salman
- e Institute of Urology and Andrology , Norderstedt-Hamburg , Germany
| | - Abdulla Al-Ansari
- a Department of Urology , Hamad Medical Corporation , Doha , Qatar
- b Weill Cornell Medical College in Qatar , Doha , Qatar
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12
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Abstract
We evaluated the impact of total prostate volume (TPV) on the international index of erectile function-5 (IIEF) and the premature ejaculation diagnostic tool (PEDT). A cross-sectional study was conducted that included 8336 men who had participated in a health examination. PEDT, IIEF and transrectal ultrasonography were used. A full metabolic work-up and serum testosterone level checks were also performed. The median age of participants was 51.0 years. In total, 40.1% had IIEF scores ≤16. Additionally, 24.7% were classified as demonstrating premature ejaculation (PE) (PEDT > 10). The severity of erectile dysfunction (ED) significantly increased with the TPV (p trend < 0.001). After adjusting for potential confounding factors, the odds ratio (OR) for IIEF scores ≤ 16 significantly increased in the group with TPVs of 30-39 cm(3) and the group with TPVs ≥ 40 cm(3) compared with the group with TPVs ≤ 19 cm(3) (TPV 30-39 cm(3), OR: 1.204, 95% confidence interval: 1.034-1.403; TPV ≥ 40 cm(3), OR: 1.326: 95% confidence interval: 1.051-1.733) and this relationship was maintained after adjusting for propensity score (TPV ≥ 30 cm(3), OR: 1.138: 95% confidence interval: 1.012-1.280). However, neither PEDT nor PE was correlated with TPV. In conclusion, TPV is significantly and independently correlated with IIEF but not with PEDT. Future investigations should explore the temporal relationship between TPV and ED.
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Affiliation(s)
- Jun Ho Lee
- a Department of Urology , National Police Hospital , Seoul , Korea and
| | - Sung Won Lee
- b Department of Urology , Samsung Medical Center, Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine , Seoul , Korea
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13
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Majzoub A, Arafa M, Al-Said S, Dabbous Z, Aboulsoud S, Khalafalla K, Elbardisi H. Premature ejaculation in type II diabetes mellitus patients: association with glycemic control. Transl Androl Urol 2016; 5:248-54. [PMID: 27141454 PMCID: PMC4837318 DOI: 10.21037/tau.2016.03.11] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Background Premature ejaculation (PE) is a highly prevalent sexual dysfunction among patients with diabetes mellitus (DM). Despite this, the underlying mechanism of this association is poorly understood. In this study, we aimed to investigate the prevalence of PE in a group of patients with DM and explore possible associations linking both conditions together. Methods This was a prospective study of subjects recruited with advertisement pamphlets and whose sexual function was assessed using the international index of erectile function-5 (IIEF-5) and the Arabic index of premature ejaculation (AIPE) questionnaires together with stopwatch measured intravaginal ejaculatory latency time (ELT). Participants were divided into two groups; group A subjects had DM and group B were healthy adult males. Results A total of 488 subjects were recruited. Group A included 199 (40.8%) subjects, while group B included 289 (59.2%). The prevalence of PE and ED was significantly higher in group A subjects (P<0.001). Mean ELT ± standard deviation (SD) was 3.6±2.7 in group A versus 4.3±2.8 in group B (P<0.014). Diabetic patients with erectile dysfunction (ED) showed a significantly higher incidence of PE with significantly shorter ELT. Conclusions PE is more prevalent in diabetic patients. DM is a multi-systemic disorder with complications that could help explain the pathophysiology of PE.
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Affiliation(s)
- Ahmad Majzoub
- 1 Department of Urology, Hamad Medical Corporation, Doha, Qatar ; 2 Department of Andrology, Cairo University, Cairo, Egypt ; 3 Department of Endocrinology, Hamad Medical Corporation, Doha, Qatar ; 4 Department of Internal Medicine, Cairo University, Cairo, Egypt
| | - Mohamed Arafa
- 1 Department of Urology, Hamad Medical Corporation, Doha, Qatar ; 2 Department of Andrology, Cairo University, Cairo, Egypt ; 3 Department of Endocrinology, Hamad Medical Corporation, Doha, Qatar ; 4 Department of Internal Medicine, Cairo University, Cairo, Egypt
| | - Sami Al-Said
- 1 Department of Urology, Hamad Medical Corporation, Doha, Qatar ; 2 Department of Andrology, Cairo University, Cairo, Egypt ; 3 Department of Endocrinology, Hamad Medical Corporation, Doha, Qatar ; 4 Department of Internal Medicine, Cairo University, Cairo, Egypt
| | - Zeinab Dabbous
- 1 Department of Urology, Hamad Medical Corporation, Doha, Qatar ; 2 Department of Andrology, Cairo University, Cairo, Egypt ; 3 Department of Endocrinology, Hamad Medical Corporation, Doha, Qatar ; 4 Department of Internal Medicine, Cairo University, Cairo, Egypt
| | - Samar Aboulsoud
- 1 Department of Urology, Hamad Medical Corporation, Doha, Qatar ; 2 Department of Andrology, Cairo University, Cairo, Egypt ; 3 Department of Endocrinology, Hamad Medical Corporation, Doha, Qatar ; 4 Department of Internal Medicine, Cairo University, Cairo, Egypt
| | - Kareim Khalafalla
- 1 Department of Urology, Hamad Medical Corporation, Doha, Qatar ; 2 Department of Andrology, Cairo University, Cairo, Egypt ; 3 Department of Endocrinology, Hamad Medical Corporation, Doha, Qatar ; 4 Department of Internal Medicine, Cairo University, Cairo, Egypt
| | - Haitham Elbardisi
- 1 Department of Urology, Hamad Medical Corporation, Doha, Qatar ; 2 Department of Andrology, Cairo University, Cairo, Egypt ; 3 Department of Endocrinology, Hamad Medical Corporation, Doha, Qatar ; 4 Department of Internal Medicine, Cairo University, Cairo, Egypt
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Prevalence and risk factors for erectile dysfunction and lower urinary tract symptoms in Russian Federation men: analysis from a national population-based multicenter study. Int J Impot Res 2016; 28:74-9. [DOI: 10.1038/ijir.2016.8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Revised: 10/04/2015] [Accepted: 11/23/2015] [Indexed: 11/09/2022]
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Yang Y, Liu R, Jiang H, Hong K, Zhao L, Tang W, Mao J. Association Between Dosage Frequency and the Treatment Outcomes of Sildenafil in Young and Middle-aged Men With Erectile Dysfunction: A Chinese, Multicenter, Observational Study. Urology 2015; 86:62-7. [PMID: 26142584 DOI: 10.1016/j.urology.2015.03.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Revised: 03/09/2015] [Accepted: 03/13/2015] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To evaluate the correlation between the dosage frequency of sildenafil and its treatment outcomes in men with erectile dysfunction (ED). METHODS Data were from a 4-week, multicenter, observational study of men (1699), between 18 and 60 years of age, with a clinical diagnosis of ED defined as the Sexual Health Inventory for Men (SHIM) score ≤21. The erectile function and quality of sexual life were evaluated at the baseline and the endpoint of sildenafil treatment (after 4 weeks) by using SHIM, Self-Esteem and Relationship Questionnaire, 36-Item Short Form Health Survey, Erection Hardness Score, and the global efficacy question. RESULTS Nine hundred thirty-five patients were enrolled in the ≤1 weekly, 573 in the 2-3 weekly, and 158 in the 4-7 weekly dosage frequency cohorts. After 4 weeks of treatment, a higher dosage frequency of sildenafil was associated with a better SHIM, Self-Esteem and Relationship Questionnaire, and 36-Item Short Form Health Survey score improvement (all P <.0001). Hyperlipidemia is a poor prognostic factor (odds ratio, 3.59; P = .04), whereas hypertension (odds ratio, 0.25; P <.01) and coronary heart disease (odds ratio, 0.56; P = .05) are sensitive to sildenafil treatment. CONCLUSION Higher dosage frequency of sildenafil is associated with a better improvement of sexual function and quality of life of men with ED, and the concomitant treatment of hyperlipidemia is recommended.
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Affiliation(s)
- Yi Yang
- Reproductive Medical Center, First Hospital of Jilin University, Changchun, China
| | - Ruizhi Liu
- Reproductive Medical Center, First Hospital of Jilin University, Changchun, China
| | - Hui Jiang
- Department of Urology, Peking University Third Hospital, Beijing, China.
| | - Kai Hong
- Department of Urology, Peking University Third Hospital, Beijing, China
| | - Lianming Zhao
- Department of Urology, Peking University Third Hospital, Beijing, China
| | - Wenhao Tang
- Department of Urology, Peking University Third Hospital, Beijing, China
| | - Jiaming Mao
- Department of Urology, Peking University Third Hospital, Beijing, China
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