Serum Arginase II level can be a novel indicator for erectile dysfunction in patients with vasculogenic erectile dysfunction: a comparative study

Erectile Dysfunction: Treatments, Advances and New Therapeutic Strategies

Erectile dysfunction (ED) is the inability to get and maintain an adequate penile erection for satisfactory sexual intercourse. Due to its negative impacts on men's life quality and increase during aging (40% of men between 40 and 70 years), ED has always attracted researchers of different disciplines, from urology, andrology and neuropharmacology to regenerative medicine, and vascular and prosthesis implant surgery. Locally and/or centrally acting drugs are used to treat ED, e.g., phosphodiesterase 5 inhibitors (first in the list) given orally, and phentolamine, prostaglandin E1 and papaverine injected intracavernously. Preclinical data also show that dopamine D4 receptor agonists, oxytocin and α-MSH analogues may have a role in ED treatment. However, since pro-erectile drugs are given on demand and are not always efficacious, new strategies are being tested for long lasting cures of ED. These include regenerative therapies, e.g., stem cells, plasma-enriched platelets and extracorporeal shock wave treatments to cure damaged erectile tissues. Although fascinating, these therapies are laborious, expensive and not easily reproducible. This leaves old vacuum erection devices and penile prostheses as the only way to get an artificial erection and sexual intercourse with intractable ED, with penile prosthesis used only by accurately selected patients.

Diagnostic work up: Laboratory and biomarkers

This chapter will focus on the diagnostic work around sexual dysfunction in Parkinson's disease, especially laboratory tests and biomarkers. A number of methods to analyze if sexual dysfunction is caused by neural pathology, vascular dysfunction or other mechanisms are now available. Other methods can be used to differentiate between psychogenic/functional reasons behind sexual dysfunction and organic ones. The role of biomarkers for diagnosis, but also for understanding the reason behind and for counteracting sexual dysfunction is becoming more evident. There is also a rich and increasing number of scales and other instruments available for detecting and quantifying sexual hypo- and hyperactivity. When investigating the reason behind sexual dysfunction in patients with Parkinson's disease comorbidities should also be considered. Finally, early and pronounced sexual dysfunction might in some cases be an indication that differential diagnosis, like Multisystem Atrophy, should be thought about. All these aspects of the diagnostic procedures around sexual dysfunction in Parkinson's disease will be covered in this chapter.

Almond-supplemented diet improves sexual functions beyond Phosphodiesterase-5 inhibition in diabetic male rats

Hyperglycemia, an important feature of diabetes, can cause oxidative stress, which is associated with varieties of diabetic complications including erectile dysfunction. Therefore, this study sought to investigate the effect of almond-supplemented diet on some biochemical indices relevant to erection in diabetic male rats. Forty-two male rats were divided into two groups: A (n = 6) and B (n = 36). Diabetes was induced in Group B via injection of a single dose of STZ (50 mg/kg) intraperitoneally and confirmed 72 h after induction. Diabetic rats (blood glucose ≥250 mg/dL) were subsequently divided into six groups (n = 6). Fourteen days after confirmation of diabetes, rats were fed with diets containing almond drupe and seeds (10 and 20% inclusion) for fourteen days. The effects of the diets on blood glucose, sexual behavior, sexual hormones, phosphodiesterase-5 activity, nitric oxide, H₂S, and AGEs levels were evaluated. Significant increase in blood glucose level, phosphodiesterase-5 activity, and glycated hemoglobin was observed in diabetic rats. Furthermore, diabetes caused a significant decrease in nitric oxide, H₂S, sexual hormones (testosterone, follicle-stimulating hormone and luteinizing hormone) levels, and sexual behavioral indices. However, treatment with diets supplemented with almond drupe and seeds significantly reversed these effects in diabetic rats. Findings in this study revealed that almond-supplemented diets enhance some important biomarkers relevant to erection in diabetic rats. Thus, dietary inclusion of almond (drupe and seeds) could serve as a cheap and readily available nutraceutical in the management of erectile dysfunction associated with diabetes.