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Blitshteyn S, Lange A, Corinaldi C, Guy P, Brook J. Sexual Dysfunction in Postural Orthostatic Tachycardia Syndrome (POTS): A Cross-Sectional, Case-Control Study. J Clin Med 2024; 13:2274. [PMID: 38673548 PMCID: PMC11050785 DOI: 10.3390/jcm13082274] [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: 03/21/2024] [Revised: 04/03/2024] [Accepted: 04/12/2024] [Indexed: 04/28/2024] Open
Abstract
Background: We aimed to determine whether patients with postural orthostatic tachycardia syndrome (POTS) have sexual dysfunction compared to age-matched healthy controls. Methods: Utilizing online COMPASS-31 to evaluate dysautonomia symptom severity, Beck's Depression Inventory Second Edition (BDII), Female Sexual Function (FSF), and International Index of Erection Function (IIEF) questionnaires, we compared sexual function scores in patients with POTS to scores obtained from sex- and age-matched healthy controls via a cross-sectional case-control study. Results: A total of 160 women with POTS, mean age 30.2 ± 7.9 (range 21-50 years), had lower FSF scores than 62 healthy age-matched female controls. IIEF scores in 29 male patients with POTS with a mean age of 30.1 ± 6.0 (range 21-47) were significantly lower than in 27 healthy age-matched male controls. Female POTS patients had significantly lower scores in the sub-domains of desire, arousal, and satisfaction, while male POTS patients had significantly lower scores in erectile and orgasmic function, desire, and satisfaction than healthy controls. Predictive factors of sexual dysfunction were depression in women and age in men. The severity of autonomic symptoms correlated with sexual dysfunction in women, but this effect disappeared after controlling for depression. Conclusions: Compared to healthy controls, women and men with POTS have significant sexual dysfunction, which needs to be considered in the diagnostic and therapeutic approaches as part of comprehensive patient care.
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Affiliation(s)
- Svetlana Blitshteyn
- Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY 14203, USA
- Dysautonomia Clinic, Williamsville, NY 14221, USA
| | - Anna Lange
- Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY 14203, USA
| | - Chelsea Corinaldi
- Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY 14203, USA
| | - Paige Guy
- Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY 14203, USA
| | - Jill Brook
- Dysautonomia Clinic, Williamsville, NY 14221, USA
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2
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Lin W, Wang H, Lin ME. Relationship Between Systemic Inflammatory Response Index and Erectile Dysfunction: A Cross-sectional Study. Urology 2023; 181:69-75. [PMID: 37673404 DOI: 10.1016/j.urology.2023.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 08/08/2023] [Accepted: 08/17/2023] [Indexed: 09/08/2023]
Abstract
OBJECTIVE To explore the association between systemic inflammation response index (SIRI) and erectile dysfunction (ED) in American men. METHODS Data from the National Health and Nutrition Examination Survey (NHANES) between 2001 and 2004 were used. Multivariate logistic regression and restricted cubic spline were used to evaluate the relationship between SIRI and ED. Interaction analysis was performed for subgroups to verify the results. Meanwhile, 1:1 propensity score matching was performed to adjust for potential confounding factors for data reanalysis to confirm the reliability of the results. RESULTS A total of 3543 US adults aged 20years or older were included in the study, of whom 955 participants were considered to have ED. After adjusting for potential confounding factors, we found that compared with the lowest tertiles, the highest tertiles of SIRI showed a positive association with ED, which odd ratio was 1.70 (95%CI: 1.16-2.50). Dose-response curve analysis showed a positive linear correlation between SIRI and ED prevalence. And in the subgroup analysis, the interaction analysis showed that the results were consistent. Meanwhile, the matching of propensity scores further confirmed the validity of the results. CONCLUSION In conclusion, in this cross-sectional study, we found a positive relationship between SIRI and the prevalence of ED. Further experimental studies are needed to explore the underlying mechanism in the future.
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Affiliation(s)
- Weilong Lin
- The First Affiliated Hospital of Shantou University Medical College, Medical College of Shantou University, Shantou, China
| | - Haoxu Wang
- The First Affiliated Hospital of Shantou University Medical College, Medical College of Shantou University, Shantou, China
| | - Ming-En Lin
- The First Affiliated Hospital of Shantou University Medical College, Medical College of Shantou University, Shantou, China.
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3
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Ajayi AF, Onaolapo MC, Omole AI, Adeyemi WJ, Oluwole DT. Mechanism associated with changes in male reproductive functions during ageing process. Exp Gerontol 2023; 179:112232. [PMID: 37315721 DOI: 10.1016/j.exger.2023.112232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 06/07/2023] [Accepted: 06/10/2023] [Indexed: 06/16/2023]
Abstract
Ageing is a natural process with physiological changes in different body parts and has been associated with decreased reproductive capacity. Factors such as imbalance in the antioxidant defence system, vascular diseases, diabetes mellitus, accessory reproductive glands infection, obesity as well as buildup of toxic substances play a role in age-related male reproductive malfunction. Age is inversely proportional to volume of semen, sperm count, sperm progressive motility, sperm viability, normal sperm morphology. The observed negative correlation between ageing and semen indices contributes to male infertility and reproductive decline. Normal levels of ROS, plays crucial role in facilitating sperm function, such as capacitation, hyper-activation, acrosome reaction as well as sperm-oocyte fusion; however, a substantial elevation in the endogenous level of ROS, especially in reproductive tissues, usually instigates destruction of sperm cells and heightened male infertility. Contrarily, antioxidants, such as vitamins C and E, beta-carotene, and micronutrients like zinc and folate, have been found by researchers to facilitate normal semen quality and male reproductive function. Furthermore, the role of hormonal imbalance as a result of the compromised hypothalamic-pituitary-gonadal axis, Sertoli and Leydig cells disorder, and nitric oxide-medicated erectile dysfunction during ageing cannot be undermined.
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Affiliation(s)
- Ayodeji Folorunsho Ajayi
- Department of Physiology, Ladoke Akintola University of Technology, Ogbomoso, Oyo State, Nigeria; Anchor Biomed Research Institute, Ogbomoso, Oyo State, Nigeria.
| | | | - Ayomide Isaac Omole
- Department of Physiology, Ladoke Akintola University of Technology, Ogbomoso, Oyo State, Nigeria
| | | | - David Tolulope Oluwole
- Department of Physiology, Ladoke Akintola University of Technology, Ogbomoso, Oyo State, Nigeria; Department of Physiology, Crescent University, Abeokuta, Ogun-State, Nigeria
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4
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Allen MS, Tostes RC. Cigarette smoking and erectile dysfunction: an updated review with a focus on pathophysiology, e-cigarettes, and smoking cessation. Sex Med Rev 2023. [DOI: 10.1093/sxmrev/qeac007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Abstract
Introduction
Cigarette smoking has major health implications and causes substantial damage to all organ systems. Approximately one-third of men are active smokers worldwide, and most men are unaware that cigarette smoking can contribute to erectile dysfunction (ED).
Objectives
This article aims to provide a comprehensive overview of research conducted on cigarette smoking and ED, with a particular focus on pathophysiology, electronic cigarettes (e-cigarettes), and smoking cessation.
Methods
A manual literature search was conducted on all research conducted on cigarette smoking and ED up to October 2022.
Results
Substantial evidence is now available showing that past and current cigarette smoking has dose-dependent associations with ED in studies controlling for age and important health comorbidities. Cigarette smoke contains nicotine, carbon monoxide, oxidant chemicals, and metals that can damage the endothelium and disrupt erectile processes. For current smokers, smoking abstinence can strengthen the endothelium and reverse diminished erectile function. The effect of e-cigarettes on endothelial damage and ED remains largely untested. E-cigarettes expose users to fine and ultrafine particles and toxins that can increase risk of cardiovascular injury, but these acute effects appear less potent than conventional cigarettes (long-term cardiovascular effects are still unknown). E-cigarettes are therefore likely to have less harmful effects on ED than conventional cigarettes.
Conclusions
Smoking cessation programs that focus on nicotine replacement therapy (transdermal patches, gum, or inhalers), behavioral counseling, social support, and education programs can be effective approaches to ED treatment in active smokers. Temporarily transferring from regular cigarettes to e-cigarettes—which transmit some of the same carcinogens as conventional cigarettes and are likely to have some long-term cardiovascular effects that disrupt erectile function—might also be useful for long-term smoking cessation and treatment of ED.
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Affiliation(s)
- Mark S Allen
- Department of Psychology and Therapeutic Studies , Leeds Trinity University, Leeds, LS18 5HD, UK
| | - Rita C Tostes
- Department of Pharmacology, University of São Paulo , São Paulo, Brazil
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5
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Franco I. Anatomy, physiology, and evaluation: Bowel, bladder, and sexual disorders. HANDBOOK OF CLINICAL NEUROLOGY 2023; 196:403-423. [PMID: 37620081 DOI: 10.1016/b978-0-323-98817-9.00009-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
Our present understanding of bowel and bladder control has changed dramatically with the introduction of functional imagining technologies such as PET, SPECT, fMRI scanning, and near-infrared spectroscopy of the brain. Urologists tend to see control of urination and defecation as processes that occurred at or below the level of the pons for the most part. In this chapter, we examine the control of storing and emptying of urine and stool from what will be a more neurocentric perspective, integrating the frontal lobes into the process and moving beyond the pons on which most of the literature has focused in the past. Utilizing this approach gives us a better understanding of why there is an overlapping of neuropsychiatric problems in many patients with voiding dysfunction.
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Affiliation(s)
- Israel Franco
- Yale School of Medicine, Yale-New Haven Children's Bladder and Continence Program, Yale New Haven Children's Hospital, New Haven, CT, United States.
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Abstract
Purpose: COVID-19, a novel infection, presented with several complications, including socioeconomical and reproductive health challenges such as erectile dysfunction (ED). The present review summarizes the available shreds of evidence on the impact of COVID-19 on ED.Materials and methods: All published peer-reviewed articles from the onset of the COVID-19 outbreak to date, relating to ED, were reviewed. Results: Available pieces of evidence that ED is a consequence of COVID-19 are convincing. COVID-19 and ED share common risk factors such as disruption of vascular integrity, cardiovascular disease (CVD), cytokine storm, diabetes, obesity, and chronic kidney disease (CKD). COVID-19 also induces impaired pulmonary haemodynamics, increased ang II, testicular damage and low serum testosterone, and reduced arginine-dependent NO bioavailability that promotes reactive oxygen species (ROS) generation and endothelial dysfunction, resulting in ED. In addition, COVID-19 triggers psychological/mental stress and suppresses testosterone-dependent dopamine concentration, which contributes to incident ED.Conclusions: In conclusion, COVID-19 exerts a detrimental effect on male reproductive function, including erectile function. This involves a cascade of events from multiple pathways. As the pandemic dwindles, identifying the long-term effects of COVID-19-induced ED, and proffering adequate and effective measures in militating against COVID-19-induced ED remains pertinent.
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Affiliation(s)
- D H Adeyemi
- Department of Physiology, Faculty of Basic Medical Sciences, College of Health Sciences, Osun State University, Nigeria
| | - A F Odetayo
- Department of Physiology, University of Ilorin, Ilorin, Nigeria
- Reproductive Biology and Toxicology Research Laboratory, Oasis of Grace Hospital, Osogbo, Nigeria
| | - M A Hamed
- Reproductive Biology and Toxicology Research Laboratory, Oasis of Grace Hospital, Osogbo, Nigeria
- The Brainwill Laboratories, Osogbo, Nigeria
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Afe Babalola University, Ado-Ekiti, Nigeria
| | - R E Akhigbe
- Reproductive Biology and Toxicology Research Laboratory, Oasis of Grace Hospital, Osogbo, Nigeria
- Department of Physiology, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
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Cysteine-Rich Whey Protein Isolate (CR-WPI) Ameliorates Erectile Dysfunction by Diminishing Oxidative Stress via DDAH/ADMA/NOS Pathway. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:8151917. [PMID: 35355865 PMCID: PMC8960025 DOI: 10.1155/2022/8151917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 02/24/2022] [Accepted: 03/01/2022] [Indexed: 12/02/2022]
Abstract
Nitric oxide synthase- (NOS-) dependent endothelial dysfunction induced by oxidative stress (OS) is assumed to play a pivotal role in the pathogenesis and progression of diabetes mellitus-related erectile dysfunction (DMED). Cysteine-rich whey protein isolate (CR-WPI) is a widely used protein supplement and has been confirmed to reduce reactive oxygen species (ROS) by increasing cellular antioxidant glutathione (GSH). However, it is currently unknown whether CR-WPI elicits therapeutic effects in DMED. Here, we provide diabetic rats with CR-WPI to determine its effect on DMED and the underlying mechanisms. The results suggest that CR-WPI supplementation increased GSH biosynthesis and reduced ROS content and simultaneously upregulated the dimethylarginine dimethylaminohydrolase (DDAH)/asymmetrical dimethylarginine (ADMA)/nitric oxide synthase (NOS) metabolic pathway. Evaluation of intracavernous pressure (ICP) also showed an improvement of penile erectile function in CR-WPI-treated rats. The results of the vitro cell culture showed that glutathione pretreatment protected corpus cavernosum smooth muscle cells (CCSMC) from H2O2-induced apoptosis by decreasing Caspase 9 and Caspase 3 expressions. These results augur well for the potential therapeutic application of dietary CR-WPI supplementation for treating diabetic erectile dysfunction.
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Cyperus esculentus L. and Tetracarpidium conophorum Müll. Arg. Supplemented Diet Improved Testosterone Levels, Modulated Ectonucleotidases and Adenosine Deaminase Activities in Platelets from L-NAME-Stressed Rats. Nutrients 2021; 13:nu13103529. [PMID: 34684530 PMCID: PMC8541559 DOI: 10.3390/nu13103529] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 09/22/2021] [Accepted: 09/24/2021] [Indexed: 02/07/2023] Open
Abstract
In hypertensive individuals, platelet morphology and function have been discovered to be altered, and this has been linked to the development of vascular disease, including erectile dysfunction (ED). The impact of nutritional supplementation with Cyperus esculentus (tiger nut, TN) and Tetracarpidium conophorum (walnut, WN) on androgen levels, ectonucleotidases, and adenosine deaminase (ADA) activities in platelets from L-NAME (Nω-nitro-L-arginine methyl ester hydrochloride) challenged rats were investigated. We hypothesized that these nuts may show a protective effect on platelets aggregation and possibly enhance the sex hormones, thereby reverting vasoconstriction. Wistar rats (male; 250-300 g; n = 10) were grouped into seven groups as follows: basal diet control group (I); basal diet/L-NAME/Viagra (5 mg/kg/day) as positive control group (II); ED-induced group (basal diet/L-NAME) (III); diet supplemented processed TN (20%)/L-NAME (IV); diet supplemented raw TN (20%)/L-NAME (V); diet supplemented processed WN (20%)/L-NAME (VI); and diet supplemented raw WN (20%)/L-NAME (VII). The rats were given their regular diet for 2 weeks prior to actually receiving L-NAME (40 mg/kg/day) for ten days to induce hypertension. Platelet androgen levels, ectonucleotidases, and ADA were all measured. L-NAME considerably lowers testosterone levels (54.5 ± 2.2; p < 0.05). Supplementing the TN and WN diets revealed improved testosterone levels as compared to the control (306.7 ± 5.7), but luteinizing hormone levels remained unchanged. Compared to control groups, the L-NAME-treated group showed a rise in ATP (127.5%) hydrolysis and ADA (116.7%) activity, and also a decrease in ADP (76%) and AMP (45%) hydrolysis. Both TN and WN supplemented diets resulted in substantial (p < 0.05) reversal effects. Enhanced testosterone levels and modulation of the purinergic system in platelets by TN and WN could be one of the mechanisms by which they aid in vasoconstriction control.
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Loh-Doyle JC, Bhanvadia SK, Han J, Ghodoussipour S, Cai J, Wayne K, Schuckman AK, Djaladat H, Daneshmand S. Patient Reported Sexual Function Outcomes in Male Patients Following Open Radical Cystoprostatectomy and Urinary Diversion. Urology 2021; 157:161-167. [PMID: 34298032 DOI: 10.1016/j.urology.2021.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 06/23/2021] [Accepted: 07/08/2021] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To report sexual health outcomes in male patients undergoing open radical cystoprostatectomy using a validated questionnaire. MATERIALS AND METHODS Beginning in 2017, male patients were asked to complete a validated questionnaire during scheduled post-cystectomy clinic visits that assessed sexual function using the 5 item International Index of Erectile Function (IIEF-5) and supplemental questions which evaluated libido, orgasm, partner interest, and adequacy of pre-operative counselling. Baseline data and functional outcomes were compared and multivariable analysis performed. RESULTS A total of 134 patients who met inclusion criteria completed the questionnaire. Pre-operative IIEF-5 was available in 78 patients with a median score of 16 (IQR:5-23). In those patients, median age at cystectomy was 68.9 years (IQR:60.2-72.4) and median duration of follow-up was 17.3 months (IQR:6.3-28.7). Median IIEF-5 score at time of survey completion was 1 (IQR:1-11). Increasing age, shorter follow-up duration, insufficient counselling, and absence of partner interest were predictive of lower scores. Younger age, pre-operative erectile function, and neurovascular preservation were predictive of a higher IIEF-5 score on univariate and multivariate analysis. Median libido score was 2 "low" (IQR:1-3) and ability to orgasm was reported by 34 (43.6%) patients. Neurovascular preservation (OR:3.03 95% CI:1.10-8.26, P = .03) and sufficient preoperative counselling (OR:3.078 95% CI:1.17-8.098, P = .02) were associated with preserved ability to orgasm. Libido was influenced by partner interest (OR 11.7, 95% CI:3.793-6.14, P <.0001). CONCLUSION Sexual dysfunction after radical cystoprostatectomy is prevalent with many contributing factors. As such, establishing appropriate expectations and goals during preoperative counseling, performing neurovascular preservation when appropriate, and readily identifying and treating dysfunction in follow-up may improve sexual recovery.
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Affiliation(s)
- Jeffrey C Loh-Doyle
- Department of Urology, USC Institute of Urology, USC/Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA.
| | - Sumeet K Bhanvadia
- Department of Urology, USC Institute of Urology, USC/Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Jullet Han
- Department of Urology, USC Institute of Urology, USC/Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Saum Ghodoussipour
- Department of Urology, USC Institute of Urology, USC/Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Jie Cai
- Department of Urology, USC Institute of Urology, USC/Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Kevin Wayne
- Department of Urology, USC Institute of Urology, USC/Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Anne K Schuckman
- Department of Urology, USC Institute of Urology, USC/Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Hooman Djaladat
- Department of Urology, USC Institute of Urology, USC/Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Siamak Daneshmand
- Department of Urology, USC Institute of Urology, USC/Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA
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Bondar A, Popa AR, Papanas N, Popoviciu M, Vesa CM, Sabau M, Daina C, Stoica RA, Katsiki N, Stoian AP. Diabetic neuropathy: A narrative review of risk factors, classification, screening and current pathogenic treatment options (Review). Exp Ther Med 2021; 22:690. [PMID: 33986855 PMCID: PMC8111877 DOI: 10.3892/etm.2021.10122] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 02/22/2021] [Indexed: 12/15/2022] Open
Abstract
Diabetic neuropathy (DN) is a frequent complication of diabetes mellitus (DM) with severe consequences as it progresses and influences all human body systems. This review discusses the risk factors for DN, the main characteristics of the clinical forms of DN, the screening methods and the current therapeutic options. Distal symmetric DN is the primary clinical form, and DM patients should be screened for this complication. The most important treatment of DN remains good glucose control, generally defined as HbA1c ≤7%. Symptomatic treatment improves life quality in diabetic patients. Pharmacological agents such as alpha (α)-lipoic acid and benfotiamine have been validated in several studies since they act on specific pathways such as increased oxidative stress (α-lipoic acid exerts antioxidant effects) and the excessive production of advanced glycosylation products (benfotiamine may inhibit their production via the normalization of glucose). Timely diagnosis of DN is significant to avoid several complications, including lower limb amputations and cardiac arrhythmias.
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Affiliation(s)
- Andrei Bondar
- Department of Psychiatry, Clinical County Emergency Hospital of Oradea, 410169 Oradea, Romania
- Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | - Amorin Remus Popa
- Department of Psychiatry, Clinical County Emergency Hospital of Oradea, 410169 Oradea, Romania
- Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | - Nikolaos Papanas
- Second Department of Internal Medicine, ‘Democritus’ University of Thrace Diabetes Centre, 68100 Alexandroupolis, Greece
| | - Mihaela Popoviciu
- Department of Psychiatry, Clinical County Emergency Hospital of Oradea, 410169 Oradea, Romania
- Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | - Cosmin Mihai Vesa
- Department of Psychiatry, Clinical County Emergency Hospital of Oradea, 410169 Oradea, Romania
- Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | - Monica Sabau
- Department of Psychiatry, Clinical County Emergency Hospital of Oradea, 410169 Oradea, Romania
- Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | - Cristian Daina
- Department of Psychiatry, Clinical County Emergency Hospital of Oradea, 410169 Oradea, Romania
- Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | - Roxana Adriana Stoica
- Department of Diabetes, Nutrition and Metabolic Diseases, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Niki Katsiki
- Second Propaedeutic Department of Internal Medicine, AHEPA University Hospital, 54636 Thessaloniki, Greece
| | - Anca Pantea Stoian
- Department of Diabetes, Nutrition and Metabolic Diseases, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania
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Abdelhamed A, Abu El-Hamd M. Medicolegal evaluation of the erectile function of patients referred from the Forensic Medicine Authority of the Ministry of Justice in Upper Egypt. Int J Clin Pract 2021; 75:e14252. [PMID: 33884717 DOI: 10.1111/ijcp.14252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 04/16/2021] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES In Upper Egypt, the Forensic Medicine Authority of the Ministry of Justice transfers patients with marital conflicts or accusation of rape for proper sexual function evaluation, which helps in making its decisions according to the law. Therefore, our study aims to evaluate the pattern of 40 cases referred for sexual function evaluation, their clinical, laboratory, imaging characteristics and finally the decisions of these cases. METHODS The study included 40 patients who referred from the Forensic Medicine Authority for erectile function evaluation. Initial evaluation was done through history taking, general & genital examination. Hormonal profile including total testosterone, free testosterone, follicle stimulating hormone, luteinizing hormone, prolactin, estradiol and random blood sugar were done. Penile color doppler with intracorporeal injection of PGE1 was done. RESULTS The final decision for erectile function cases was considered as normal evaluation, venogenic, arteriogenic, and psychogenic erectile dysfunction were 35% (14/40), 25% (10/40), 15% (6/40) and 12.5% (5/40), respectively. CONCLUSIONS There is a great diversity in patients referred for medicolegal evaluation in Upper Egypt; with the erectile function problems are the commonest. A more meticulous well-designed approach is needed for proper evaluation of those patients as serious legal consequences result from this evaluation.
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Affiliation(s)
- Amr Abdelhamed
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Mohammed Abu El-Hamd
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Sohag University, Sohag, Egypt
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12
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Kumsar Ş, Ciğerli Ö, Hasırcı E, Akay AF, Peşkircioğlu L. The relationship between serum irisin levels and erectile dysfunction in diabetic men (irisin and erectile dysfunction in diabetic patients). Andrologia 2021; 53:e13959. [PMID: 33400308 DOI: 10.1111/and.13959] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 12/19/2020] [Accepted: 12/21/2020] [Indexed: 01/21/2023] Open
Abstract
Irisin is an exercise-induced myokine that alleviates endothelial dysfunction and reduces insulin resistance in type 2 diabetes mellitus. We conducted this cross-sectional prospective study to determine the association of serum irisin levels and erectile dysfunction in type 2 diabetic patients. We compared 34 diabetic patients with erectile dysfunction with 30 diabetic patients without erectile dysfunction. In our study, serum irisin levels were found to be statistically significantly higher in diabetic patients without erectile dysfunction compared to those with erectile dysfunction (p = .016) and according to correlation analysis, irisin levels had a significantly negative correlation with the serum HbA1C value (r = -.294, p = .018). Based on the results of our study, we think that this molecule can be used in the diagnosis or treatment of erectile dysfunction in diabetic patients, if these findings are supported by larger studies.
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Affiliation(s)
- Şükrü Kumsar
- Department of Urology, Baskent University Istanbul Hospital, İstanbul, Turkey
| | - Özlem Ciğerli
- Department of Endocrinology, Baskent University Istanbul Hospital, İstanbul, Turkey
| | - Eray Hasırcı
- Department of Urology, Baskent University Faculty of Medicine, İstanbul, Turkey
| | - Ali F Akay
- Department of Urology, Baskent University Istanbul Hospital, İstanbul, Turkey
| | - Levent Peşkircioğlu
- Department of Urology, Baskent University Faculty of Medicine, İstanbul, Turkey
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13
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Yang R, Liu C, Li Q, Wang W, Wu B, Chen A, Wang B, Li W, Chen J. Artificial intelligence based identification of the functional role of hirudin in diabetic erectile dysfunction treatment. Pharmacol Res 2021; 163:105244. [PMID: 33053440 DOI: 10.1016/j.phrs.2020.105244] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 09/28/2020] [Accepted: 10/06/2020] [Indexed: 12/15/2022]
Abstract
Diabetic erectile dysfunction (DED) hugely affected the patients' sexual life quality. However, there are no satisfactory therapeutic methods and intervention targets for this subtype of erectile dysfunction (ED). Inspired by the clinical practice of traditional Chinese medicine (TCM), we found that hirudin, the main active ingredient in the leech, could ameliorate the ED symptoms of the DED mouse model. To further reveal the underlying mechanism of hirudin, we designed a novel strategy to discover potential targets based on the diagnostic system of TCM, and found that myeloperoxidase (MPO) was a promising target of hirudin. Hirudin directly interacts with MPO and inhibits its activity, thus further decreases the content of oxidized low-density lipoprotein (ox-LDL) in serum. Our results demonstrated that the hirudin could ameliorate the symptoms of DED, and revealed the underlying mechanism of hirudin in regulating the activity of MPO.
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Affiliation(s)
- Ruocong Yang
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, 100029, China
| | - Chao Liu
- State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing, 100101, China
| | - Qianqian Li
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, 100029, China
| | - Weilu Wang
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, 100029, China
| | - Bingbing Wu
- State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing, 100101, China
| | - Aiping Chen
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, 100029, China
| | - Bin Wang
- Department of Andrology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China.
| | - Wei Li
- State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing, 100101, China.
| | - Jianxin Chen
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, 100029, China.
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14
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La Fuente JM, Sevilleja-Ortiz A, García-Rojo E, El Assar M, Fernández A, Pepe-Cardoso AJ, Martínez-Salamanca JI, Romero-Otero J, Rodríguez-Mañas L, Angulo J. Erectile dysfunction is associated with defective L-cysteine/hydrogen sulfide pathway in human corpus cavernosum and penile arteries. Eur J Pharmacol 2020; 884:173370. [PMID: 32712093 DOI: 10.1016/j.ejphar.2020.173370] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 07/09/2020] [Accepted: 07/13/2020] [Indexed: 12/24/2022]
Abstract
H2S signaling was proposed to participate in erectile physiology. L-cysteine (CYS)/H2S pathway stimulation causes cGMP-dependent relaxation of human corpus cavernosum (HCC) and penile arteries (HPRA). The aim was to evaluate the impact of ED on CYS/H2S pathway at functional and molecular level in human penile vascular tissues. NaHS- and CYS-induced responses were evaluated in HCC and HPRA from organ donors without ED (NoED, n = 29) and from ED patients undergoing penile prosthesis insertion (n = 45). cGMP accumulation and cystathionine β-synthase and cystathionine γ-lyase expression were also determined. NaHS-induced relaxations were slightly but significantly impaired in HCC but not in HPRA from ED patients. In contrast, CYS-induced relaxations were markedly impaired in HCC (Emax 67.6 ± 4.9% vs 46.2 ± 4.6%, P < 0.01) and HPRA (Emax 80.8 ± 4.0% vs 48.1 ± 8.6%, P < 0.05) from men with ED. Impairment of CYS-induced responses was observed even after separating diabetic ED patients. In HPRA from ED patients, CYS- but not NaHS-induced vasodilation was significantly associated to endothelial function measured as vasodilatory capacity of acetylcholine (ACh) in these preparations (r2 = 0.481, P < 0.01). Impairment of CYS-induced relaxations was related to significant reduction in CYS-induced accumulation of cGMP in cavernosal tissue. Furthermore, the expression of H2S synthesizing enzymes was significantly reduced in HCC from ED patients with respect to NoED. This was confirmed by immunofluorescence in HCC and HPRA sections. ED involves impairment of CYS/H2S pathway in penile vascular tissues associated with decreased expression of H2S generating enzymes, CBS and CSE. These evidences support a therapeutic potential for modulation of CYS/H2S signaling in the management of ED.
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Affiliation(s)
| | | | - Esther García-Rojo
- Servicio de Urología, Hospital Universitario Doce de Octubre, Madrid, Spain
| | | | - Argentina Fernández
- Servicio de Histología-Investigación, Hospital Universitario Ramón y Cajal - IRYCIS, Madrid, Spain
| | | | | | | | | | - Javier Angulo
- Servicio de Histología-Investigación, Hospital Universitario Ramón y Cajal - IRYCIS, Madrid, Spain.
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15
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Kamnerdsiri WA, Fox C, Weiss P. Impact of Childhood Sexual Assault on Sexual Function in the Czech Male Population. Sex Med 2020; 8:446-453. [PMID: 32593676 PMCID: PMC7471123 DOI: 10.1016/j.esxm.2020.06.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Revised: 05/26/2020] [Accepted: 06/04/2020] [Indexed: 11/17/2022] Open
Abstract
Introduction This study explores the impact of childhood sexual assault (CSA) on men's sexual function. There is limited understanding on the impact of CSA perpetrated against boys on later adult male sexual function, as there is a dearth of research on this topic. It was hypothesized that men reporting a history of CSA were more likely to report sexual function issues than men with no history of CSA. Material and methods A cross-sectional survey study of 1,004 Czech men aged between 15 and 85 years (M = 42.8 years; Standard deviation = 17.6 years) have been conducted. The participants anonymously answered a questionnaire on multiple aspects of their life and sexuality. This questionnaire included sought data on history of CSA and self-reported intravaginal ejaculation latency time and the 5-item International Index of Erectile Function. Results 25 men (2.5%) indicated a history of CSA. 71% of the perpetrators where known by the victims, with a minority declaring the crime to authorities (37.5%). Half of those reporting assault also reported sexual function issues in the present or at some time in their life. Significant correlations were recorded between a history of CSA and erectile dysfunction but not significantly with premature ejaculation. Conclusions Men who reported a history of CSA are more likely to report sexual function issues than those who do not. The identified association between CSA and sexual function issues in adult life contributes to the small body of literature on the topic. When taking a sexual history, it is recommended to practitioner to include questions about CSA, considering its correlation with erectile dysfunction. An understanding of the relationship between CSA and adult sexual function helps practitioner to improve his patient's well--being and life satisfaction. Kamnerdsiri WA, Fox C, Weiss P, et al. Impact of Childhood Sexual Assault on Sexual Function in the Czech Male Population. J Sex Med 2020;8:446–453.
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Affiliation(s)
| | - Christopher Fox
- Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Petr Weiss
- Institute of Sexology, First Faculty of Medicine, Charles University, Prague, Czech Republic
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16
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Oduyemi OA, Salami SA, Salahdeen HM, Murtala BA, Raji Y. Mechanisms of inhibitory activity of root extract of Carpolobia lutea G. Don on in vitro contractile responses of rabbit corpus carvernosum. Rev Int Androl 2020; 19:234-241. [PMID: 32593533 DOI: 10.1016/j.androl.2020.04.003] [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: 10/07/2019] [Revised: 02/08/2020] [Accepted: 04/14/2020] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Carpolobia lutea root extract (CLRE) has been reported to enhance penile erection. However, the mechanism involved is poorly understood. We investigated in vitro mechanisms of CLRE action on contractile activity of rabbit corpus cavernosum (CC). METHODS Corpus cavernosum strips from four healthy male New Zealand rabbits (2.5-3.0kg) were mounted on an organ chamber and contracted with phenylephrine (PE) (10-9 to 10-5M) and Potassium Chloride (KCl) (10-50mM) before treatment with various concentrations of CLRE (0.1-1.2mg/ml). Interactions between CLRE and a Nitric Oxide Synthase (NOS) inhibitor (N-nitro-l-arginine methyl ester - l-NAME 10-4M); guanylyl cyclase inhibitors (Oxalodiazolo 4,3-a quinoxalin-1-one - ODQ 10μM, 20μM, 30μM), and (methylene blue 10-30μM); a cyclooxygenase inhibitor (10-4M indomethacin); potassium-channel inhibitors (100μM tetraethyl ammonium TEA), (100ηM apamin) and (glibenclamide 10μM and 20μM); and a calcium-channel inhibitor (-10-4M nifedipine) were investigated. RESULTS Maximal contractions of KCl and PE contracted CC strips were significantly reduced in a concentration-dependent manner (40.8±3.6% and 38.6±4.0% from 64.6±2.9% and 98.1±4.2% respectively). Relaxant effect of CLRE was significantly reduced by ODQ (38.6±4.0% to 6.4±1.3% and 38.6±4.0% to 7.2±1.2%), nifedipine (38.6±4.0% to 21.1±2.7%) and glibenclamide (40.8±3.6% to 31.5±3.3%). However l-NAME, indomethacin, methylene blue, TEA and apamin did not inhibit relaxation by CLRE. CONCLUSION Concentration-dependent relaxant effect of CLRE in rabbit CC involves the soluble guanylate cyclase/cyclase Guanosine Monophosphate system, and activation of ATP-dependent K+ channels.
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Affiliation(s)
- Oluwatosin Aisha Oduyemi
- Department of Physiology, Reproduction and Developmental Programming Unit, University of Ibadan, Ibadan, Nigeria
| | - Shakiru Ademola Salami
- Department of Physiology, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria.
| | | | | | - Yinusa Raji
- Department of Physiology, Reproduction and Developmental Programming Unit, University of Ibadan, Ibadan, Nigeria
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17
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Gur S, Hellstrom WJ. Harnessing Stem Cell Potential for the Treatment of Erectile Function in Men with Diabetes Mellitus: From Preclinical/Clinical Perspectives to Penile Tissue Engineering. Curr Stem Cell Res Ther 2020; 15:308-320. [DOI: 10.2174/1574888x14666190828142045] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 07/10/2019] [Accepted: 08/06/2019] [Indexed: 12/20/2022]
Abstract
Background::
According to the World Health Organization, more than 150 million people
are diabetic, and this number will increase twofold by the year 2025. Diabetes-related complications
affect all body organ systems, including the penis. Diabetes-induced Erectile Dysfunction (ED) is
caused by neuropathy of the penile nerves and vasculopathy involving the smooth muscle and endothelium
of the corpus cavernosum.
Objective::
This study aims to present an overview of Stem Cell (SC) research in diabetic animal models
of ED, focusing on the function, signaling, and niches that have a prominent role in the regeneration
of cavernosal cells and penile tissues. We highlight common erectile pathologies caused by diabetes
and review relevant preclinical trials. We also discuss paracrine mechanisms of various SC therapies
involved in the repair of endothelial cells and cavernous nerves in these diabetic models.
Method::
A PubMed search was performed, with dates ranging from inception until Mar 31, 2019.
Results::
This review provides a comprehensive evaluation of the various strategies that have been
investigated for improving SC delivery methods, through preclinical literature and published clinical
trials regarding ED in men with diabetes. Various cell-type applications have benefited erectile function
in diabetic models of ED.
Conclusion::
This review examines the progress and remaining challenges in diabetes-related SC research
regarding ED. Moving forward, it is only with a combined effort of basic biology and translational
work that the potential of SC-based therapies in diabetes in ED can be realized.
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Affiliation(s)
- Serap Gur
- Department of Urology, Tulane University Health Sciences Center, New Orleans, LA, United States
| | - Wayne J.G. Hellstrom
- Department of Urology, Tulane University Health Sciences Center, New Orleans, LA, United States
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18
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Ritchie C, Ko EY. Oxidative stress in the pathophysiology of male infertility. Andrologia 2020; 53:e13581. [PMID: 32323352 DOI: 10.1111/and.13581] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 03/03/2020] [Indexed: 12/15/2022] Open
Abstract
The effects of reactive oxygen species on male fertility are governed by the oxidative paradox, defined by a delicate balance between oxidative stress and antioxidant capacity. When regulated appropriately, reactive oxygen species ensure effective function; however, when uninhibited, they represent key players in male factor infertility. Mechanisms responsible for this include oxidative destruction of sperm lipid membranes, damage to gamete DNA both by gene mutation and by direct breakdown of the DNA backbone, mitochondrial dysfunction and apoptotic cell death. Utilizing various male pathologies as case studies, we see ways in which oxidative stress has the potential to impact fertility in a negative way. Varicocele, erectile dysfunction, testicular cancer and even idiopathic male infertility highlight common mechanistic pathways, as well as subtle variations in the ways reactive oxygen species can operate. Oxidative biomarkers have emerged to better study male infertility, predict reproductive success and modify assisted reproductive technologies to minimize oxidative stress.
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Affiliation(s)
- Cayde Ritchie
- Department of Urology, Loma Linda University, Loma Linda, CA, USA
| | - Edmund Y Ko
- Department of Urology, Loma Linda University, Loma Linda, CA, USA
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19
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Pharmacology and perspectives in erectile dysfunction in man. Pharmacol Ther 2020; 208:107493. [PMID: 31991196 DOI: 10.1016/j.pharmthera.2020.107493] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 11/05/2019] [Indexed: 12/15/2022]
Abstract
Penile erection is a perfect example of microcirculation modulated by psychological factors and hormonal status. It is the result of a complex neurovascular process that involves the integrative synchronized action of vascular endothelium; smooth muscle; and psychological, neuronal, and hormonal systems. Therefore, the fine coordination of these events is essential to maintain penile flaccidity or allow erection; an alteration of these events leads to erectile dysfunction (ED). ED is defined as the consistent or recurrent inability of a man to attain and/or maintain a penile erection sufficient for sexual activity. A great boost to this research field was given by commercialization of phosphodiesterase-5 (PDE5) inhibitors. Indeed, following the discovery of sildenafil, research on the mechanisms underlying penile erection has had an enormous boost, and many preclinical and clinical papers have been published in the last 10 years. This review is structured to provide an overview of the mediators and peripheral mechanism(s) involved in penile function in men, the drugs used in therapy, and the future prospective in the management of ED. Indeed, 30% of patients affected by ED are classified as "nonresponders," and there is still an unmet need for therapeutic alternatives. A flowchart suggesting the guidelines for ED evaluation and the ED pharmacological treatment is also provided.
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20
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Hsieh CH, Hsu GL, Chang SJ, Yang SSD, Liu SP, Hsieh JT. Surgical niche for the treatment of erectile dysfunction. Int J Urol 2019; 27:117-133. [PMID: 31812157 DOI: 10.1111/iju.14157] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Accepted: 11/04/2019] [Indexed: 11/28/2022]
Abstract
Penile erection implicates arterial inflow, sinusoidal relaxation and corporoveno-occlusive function. By far the most widely recognized vascular etiologies responsible for organic erectile dysfunction can be divided into arterial insufficiency, corporoveno-occlusive dysfunction or mixed type, with corporoveno-occlusive dysfunction representing the most common finding. In arteriogenic erectile dysfunction, corpora cavernosa show lower oxygen tension, leading to a diminished volume of cavernosal smooth muscle and consequential corporoveno-occlusive dysfunction. Current studies support the contention that corporoveno-occlusive dysfunction is an effect rather than the cause of erectile dysfunction. Surgical interventions have consisted primarily of penile revascularization surgery for arterial insufficiency and penile venous surgery for corporoveno-occlusive dysfunction, whatever the mechanism. However, the surgical effectiveness remained debatable and unproven, mostly owing to the lack of consistent hemodynamic assessment, standardized select patient and validated outcome measures, as well as various surgical procedures. Penile vascular surgery has been disclaimed to be the treatment of choice based on the currently available guidelines. However, reports on penile revascularization surgery support its utility in treating arterial insufficiency in otherwise healthy patients aged <55 years with erectile dysfunction of late attributable to arterial occlusive disease. Furthermore, it is noteworthy that penile venous surgery might be beneficial for selected patients with corporoveno-occlusive dysfunction, especially with a better understanding of the innovated venous anatomy of the penis. Penile vascular surgery might remain a viable alternative for the treatment of erectile dysfunction, and could have found its niche in the possibility of obtaining spontaneous, unaided and natural erection.
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Affiliation(s)
- Cheng-Hsing Hsieh
- Department of Urology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taipei, Taiwan.,School of Medicine, Buddhist Tzu Chi University, Hualien, Taiwan
| | - Geng-Long Hsu
- Microsurgical Potency Reconstruction and Research Center, Hsu's Andrology, Taipei, Taiwan
| | - Shang-Jen Chang
- Department of Urology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taipei, Taiwan.,School of Medicine, Buddhist Tzu Chi University, Hualien, Taiwan
| | - Stephen Shei-Dei Yang
- Department of Urology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taipei, Taiwan.,School of Medicine, Buddhist Tzu Chi University, Hualien, Taiwan
| | - Shih-Ping Liu
- Department of Urology, National Taiwan University Hospital, Taipei, Taiwan.,School of Medicine, National Taiwan University, Taipei, Taiwan
| | - Ju-Ton Hsieh
- Department of Urology, National Taiwan University Hospital, Taipei, Taiwan.,School of Medicine, National Taiwan University, Taipei, Taiwan
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21
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Transplantation of Human Urine-Derived Stem Cells Ameliorates Erectile Function and Cavernosal Endothelial Function by Promoting Autophagy of Corpus Cavernosal Endothelial Cells in Diabetic Erectile Dysfunction Rats. Stem Cells Int 2019; 2019:2168709. [PMID: 31582984 PMCID: PMC6754951 DOI: 10.1155/2019/2168709] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 07/03/2019] [Accepted: 08/08/2019] [Indexed: 02/07/2023] Open
Abstract
Aims Cavernosal endothelial dysfunction is one of the factors in developing diabetic erectile dysfunction (DED), but the mechanism of cavernosal endothelial dysfunction is unclear. The present study is aimed at determining the contribution of autophagy in cavernosal endothelial dysfunction of DED rats and explaining the therapeutic effect of urine-derived stem cells (USCs). Methods After rat corpus cavernosal vascular endothelial cells (CCECs) were isolated and cultured in vitro, CCECs were treated with advanced glycation end products (AGEs) to mimic the diabetic situation. Autophagy flux, proliferation, and apoptosis of CCECs were determined by mRFP-GFP-LC3 adenovirus infection combined with fluorescence observation and western blot analysis. USCs were isolated from the urine of six healthy male donors, and coculture systems of USCs and CCECs were developed to assess the protective effect of USCs for CCECs in vitro. The contribution of autophagy to the cellular damage in CCECs was evaluated by the autophagic inhibitor, 3-methyladenine (3-MA). Then, DED rats were induced by streptozotocin (50 mg/kg) and screened by apomorphine test (100 μg/kg). In DED rats, USCs or PBS as vehicle was administrated by intracavernous injection (n = 15 per group), and another 15 normal rats served as normal controls. Four weeks after injection, erectile function was evaluated by measuring the intracavernosal pressure (ICP) and mean arterial pressure (MAP). Cavernosal endothelial function and autophagic activity were examined by western blot, immunofluorescence, and transmission electron microscopy. Results In vitro, AGE-treated CCECs displayed fewer LC3 puncta formation and expressed less LC3-II, Beclin1, and PCNA but expressed more p62 and cleaved-caspase3 than controls (p < 0.05). Coculture of USCs with CCECs demonstrated that USCs were able to protect CCECs from AGE-induced autophagic dysfunction and cellular damage, which could be abolished by 3-MA (p < 0.05). DED rats showed lower ratio of ICP/MAP, reduced expression of endothelial markers, and fewer autophagic vacuoles in the cavernosal endothelium when compared with normal rats (p < 0.05). Intracavernous injection of USCs improved erectile function and cavernosal endothelial function of DED rats (p < 0.05). Most importantly, our data showed that the repaired erectile function and cavernosal endothelial function were the result of restored autophagic activity of the cavernosal endothelium in DED rats (p < 0.05). Conclusions Impaired autophagy is involved in the cavernosal endothelial dysfunction and erectile dysfunction of DED rats. Intracavernous injection of USCs upregulates autophagic activity in the cavernosal endothelium, contributing to ameliorating cavernosal endothelial dysfunction and finally improving the erectile dysfunction induced by diabetes.
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22
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Leisegang K, Henkel R, Agarwal A. Obesity and metabolic syndrome associated with systemic inflammation and the impact on the male reproductive system. Am J Reprod Immunol 2019; 82:e13178. [DOI: 10.1111/aji.13178] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 07/08/2019] [Accepted: 07/23/2019] [Indexed: 02/06/2023] Open
Affiliation(s)
- Kristian Leisegang
- School of Natural Medicine University of the Western Cape Bellville Cape Town South Africa
| | - Ralf Henkel
- Department of Medical Biosciences University of the Western Cape Bellville Cape Town South Africa
- Department of Urology American Center for Reproductive Medicine Cleveland Clinic Cleveland Ohio
| | - Ashok Agarwal
- Department of Urology American Center for Reproductive Medicine Cleveland Clinic Cleveland Ohio
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23
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Chung SD, Liu JC, Lou TN, Shia BC, Lin HC, Kao LT. Relation Between Mitral Valve Prolapse and Erectile Dysfunction (from a Nationwide Case-Control Study). Am J Cardiol 2019; 124:1590-1593. [PMID: 31514966 DOI: 10.1016/j.amjcard.2019.08.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Revised: 08/01/2019] [Accepted: 08/02/2019] [Indexed: 11/29/2022]
Abstract
Some previous literature indicated an association between cardiovascular diseases and erectile dysfunction (ED). This case-control study purposed to evaluate the association between prior mitral valve prolapse (MVP) and ED using data from the Taiwan National Health Insurance Research Dataset. In this study, 48,755 patients with ED were identified as cases, and 195,020 propensity score-matched patients without ED were selected as controls. Conditional logistic regressions were conducted to evaluate the odds ratios (ORs) for previous MVP between cases and the matched controls. In all sampled patients, 4,565 (1.87%) patients had MVP before the index date. MVP was found in 1,304 (2.67%) cases and in 3,261 (1.67%) matched controls. Patients with ED had a significantly higher occurrence of MVP than the controls. In addition, after propensity score matching, a conditional logistic regression analysis showed that the OR of previous MVP for patients with ED was 1.63 (95% confidence interval [CI] 1.52 to 1.74) compared to the matched controls. The ORs of previous MVP for patients with ED aged ≤65 years and those >65 years were 1.68 (95% CI 1.56 to 1.81) and 1.49 (95% CI 1.30 to 1.70), respectively, compared with the matched controls. We found that patients with erectile dysfunction had significantly higher odds of previous MVP compared with matched control subjects without ED regardless of the age group.
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Affiliation(s)
- Shiu-Dong Chung
- Division of Urology, Department of Surgery, Far Eastern Memorial Hospital, Taipei, Taiwan; Sleep Research Center, Taipei Medical University Hospital, Taipei, Taiwan
| | - Ju-Chi Liu
- Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of Cardiovascular Medicine, Department of Medicine, Medical University Hospital-Shuang Ho Hospital, Taipei, Taiwan
| | - Tsai-Ning Lou
- School of Health Care Administration, Taipei Medical University, Taipei, Taiwan
| | - Ben-Chang Shia
- Big Data Research Center, Taipei Medical University, Taipei, Taiwan
| | - Herng-Ching Lin
- Sleep Research Center, Taipei Medical University Hospital, Taipei, Taiwan; School of Health Care Administration, Taipei Medical University, Taipei, Taiwan
| | - Li-Ting Kao
- Sleep Research Center, Taipei Medical University Hospital, Taipei, Taiwan; Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan; Department of Pharmacy Practice, Tri-Service General Hospital, Taipei, Taiwan; School of Pharmacy, National Defense Medical Center, Taipei, Taiwan.
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24
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Yang Y, Song Y, Lu Y, Xu Y, Liu L, Liu X. Associations between erectile dysfunction and psychological disorders (depression and anxiety): A cross-sectional study in a Chinese population. Andrologia 2019; 51:e13395. [PMID: 31434163 DOI: 10.1111/and.13395] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 06/26/2019] [Accepted: 07/20/2019] [Indexed: 12/21/2022] Open
Abstract
The present cross-sectional survey was performed to evaluate the prevalences and correlations of depression and anxiety among Chinese erectile dysfunction (ED) men. Between February 2017 and January 2019, male patients with or without ED treated in andrology clinic and urology clinic were enrolled in the investigation. All enrolled patients were required to fill in the International Index of Erectile Function Questionnaire (IIEF-5), Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder 7-item scale (GAD-7) which intended to evaluate the diagnosis and severity of ED, depression and anxiety respectively. Of the 958 included participants, 79.82% (613/768) and 79.56% (611/768) ED patients appeared to have anxiety and depression; 13.68% (26/190) of men without ED had anxiety and depression. In addition, young ED patients (age ≤35 years) and long ED duration patients (duration >12 months) had higher incidences and severities of anxiety and depression (p < .05). After adjusting the age, IIEF-5 was negatively correlated with PHQ-9 (adjusted r = -.653, p < .001) and GAD-7 scores (adjusted r = -.607, p < .001). The prevalences of anxiety and depression were 79.82% and 79.56% in Chinese ED patients. The prevalences and severities of anxiety and depression increased as the ED severity increased. Based on the high incidences of anxiety and depression among Chinese ED patients, clinicians are supposed to pay more attention to early diagnosis and therapy of psychiatric symptoms for ED patients, especially among young patients and patients with long ED duration.
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Affiliation(s)
- Yongjiao Yang
- Department of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Yuxuan Song
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
| | - Yi Lu
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
| | - Yawei Xu
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
| | - Li Liu
- Department of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Xiaoqiang Liu
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
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25
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Physical activity as an adjunct treatment for erectile dysfunction. Nat Rev Urol 2019; 16:553-562. [PMID: 31239541 DOI: 10.1038/s41585-019-0210-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2019] [Indexed: 01/04/2023]
Abstract
Increasing data are available to suggest that physical activity and lifestyle modification in general can benefit erectile function, with effect sizes comparable with established treatment options such as testosterone therapy and phosphodiesterase type 5 inhibitors. Despite this evidence, primary-care physicians are rarely afforded critical information on the underlying mechanisms through which physical activity works as a treatment, severely hampering treatment credibility for both physician and patient. Physical activity is associated with psychological and metabolic adaptations that are compatible with the adaptations required for the treatment of erectile dysfunction (ED). These adaptations include increased expression and activity of nitric oxide synthase, strengthened endothelial function, acute rises in testosterone, decreased stress and anxiety, and improved body image. Use of physical activity as a first-line treatment option for ED is limited, and explicit physical activity guidelines for the treatment of ED are required. Such guidelines should include not only a suggested exercise programme but also guidelines for physician-patient communication that might enhance patient receptivity and therapy continuation. An understanding of how physical activity affects erectile function, as well as its effectiveness in treating ED compared with other established treatments, can benefit urologists and primary-care physicians searching for noninvasive treatment options for men presenting with poor erectile function.
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Amidu N, Alhassan A, Owiredu WKBA, Alidu H, Antuamwine BB, Abdul-Wahid M. Validity and Reliability of the Golombok-Rust Inventory of Sexual Satisfaction (GRISS) in Patients With Type 2 Diabetes. JOURNAL OF SEX & MARITAL THERAPY 2019; 45:141-147. [PMID: 30040591 DOI: 10.1080/0092623x.2018.1494647] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Despite the wide use of the Golombok-Rust Inventory of Sexual Satisfaction (GRISS) in several populations, the instrument has yet to be validated among patients with type 2 diabetes. The aim of this study was to evaluate the validity and reliability of the GRISS for the estimation of clinically relevant sexual dysfunction among type 2 diabetes patients under clinical management. This cross-sectional study was conducted among a total of 136 and 126 type 2 diabetic males and females, respectively, using GRISS for male and female. Internal consistency, test-retest reliability, and scores of discriminant validity were calculated. Cronbach's alpha coefficient ranged from 0.71 to 0.90 in total samples of males and females. The values obtained were similar between the chronic diabetic patients with self-reported sexual problems and normal samples. Test-retest reliability gave fair scaling results of 0.94 overall for males and 0.97 for females using Pearson's correlation coefficient. GRISS subscales differentiated multivariately between men (F7,122 = 19.308; p = 0.000; eta2 = 0.721; power = 0.993) and women (F7,118 = 18.705; p = 0.000; eta2 = 0.526; power = 0.928) with and without sexual problems. GRISS appears to be valuable and reliable for use among the Ghanaian population. Regular use of the GRISS for the screening of sexual problems among diabetic patients appears warranted.
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Affiliation(s)
- Nafiu Amidu
- a Department of Biomedical Laboratory Science, School of Allied Health Sciences , University for Development Studies , Tamale , Ghana
| | - Abukari Alhassan
- b Department of Statistics, Faculty of Mathematical Sciences , University for Development Studies , Navrongo Campus , Ghana
| | - William K B A Owiredu
- c Department of Molecular Medicine, School of Medical Sciences , College of Health Sciences, Kwame Nkrumah University of Science and Technology , Kumasi , Ghana
| | - Huseini Alidu
- d Department of Medical Laboratory Science , University of Health and Allied Sciences , Ho , Ghana
| | - Benedict B Antuamwine
- a Department of Biomedical Laboratory Science, School of Allied Health Sciences , University for Development Studies , Tamale , Ghana
| | - Mohammed Abdul-Wahid
- e Directorate of Information Communication Technology , University for Development Studies , Tamale , Ghana
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The two phases of the clinical validation of preclinical translational mechanistic research on PDE5 inhibitors since Viagra's advent. A personal perspective. Int J Impot Res 2018; 31:57-60. [PMID: 30258189 DOI: 10.1038/s41443-018-0076-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Accepted: 08/13/2018] [Indexed: 12/26/2022]
Abstract
The FDA approval of Viagra (sildenafil) for the on demand treatment of erectile dysfunction (ED) through relaxation of the corporal and cavernosal vascular smooth muscle that results in an increase in blood flow to the corporal tissues stemmed from 2 decades of research, mainly at academic centers. This culminated in the finding of the nitric oxide/cGMP pathway as the mediator of penile erection, followed by some years of basic studies and clinical validation at Pfizer. Further on, new translational laboratory and animal research from our group initiated a second phase when we proposed an alternative therapeutic schedule and mechanism of action for PDE5 inhibitors (PDE5i) in both corporal veno-occlusive dysfunction (CVOD) and Peyronie's disease (PD), specifically, continuous long-term administration (CLTA) to achieve sustained levels of cGMP within the penis. Due to the extended half-life of the long-acting PDE5i, tadalafil, this new alternative encompasses preferentially daily administration, although shorter half-life PDE5i, like sildenafil and vardenafil work too, depending on the duration, dose, and frequency of their administration This novel use was initially supported by showing the antifibrotic/antioxidant effects of nitric oxide and cGMP, produced by the induction of iNOS, as a mechanism of defense against collagen deposition in the localized fibrotic plaque of PD in an avascular tissue, the tunica albuginea. Our studies on iNOS and the progressive diffuse fibrosis occurring in the smooth muscle in CVOD, led to proposing the CLTA of PDE5i for maintaining sustained cGMP levels both in PD and in CVOD in order to halt or regress the penile fibrosis. In CVOD, we showed that PDE5i protect the corporal smooth muscle and reduce myofibroblast activation and number, counteracting the underlying corporal tissue pathology that causes CVOD, and potentially ameliorating long-term CVOD or even curing it. This review is focused on this novel PDE5i anti-fibrotic therapeutic concept.
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Alves-Lopes RU, Neves KB, Silva MA, Olivon VC, Ruginsk SG, Antunes-Rodrigues J, Ramalho LN, Tostes RC, Carneiro FS. Functional and structural changes in internal pudendal arteries underlie erectile dysfunction induced by androgen deprivation. Asian J Androl 2018; 19:526-532. [PMID: 27391248 PMCID: PMC5566844 DOI: 10.4103/1008-682x.173935] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Androgen deficiency is strongly associated with erectile dysfunction (ED). Inadequate penile arterial blood flow is one of the major causes of ED. The blood flow to the corpus cavernosum is mainly derived from the internal pudendal arteries (IPAs); however, no study has evaluated the effects of androgen deprivation on IPA's function. We hypothesized that castration impairs IPAs reactivity and structure, contributing to ED. In our study, Wistar male rats, 8-week-old, were castrated and studied 30 days after orchiectomy. Functional and structural properties of rat IPAs were determined using wire and pressure myograph systems, respectively. Protein expression was determined by Western blot and immunohistochemistry. Plasma testosterone levels were determined using the IMMULITE 1000 Immunoassay System. Castrated rats exhibited impaired erectile function, represented by decreased intracavernosal pressure/mean arterial pressure ratio. IPAs from castrated rats exhibited decreased phenylephrine- and electrical field stimulation (EFS)-induced contraction and decreased acetylcholine- and EFS-induced vasodilatation. IPAs from castrated rats exhibited decreased internal diameter, external diameter, thickness of the arterial wall, and cross-sectional area. Castration decreased nNOS and α-actin expression and increased collagen expression, p38 (Thr180/Tyr182) phosphorylation, as well as caspase 3 cleavage. In conclusion, androgen deficiency is associated with impairment of IPA reactivity and structure and increased apoptosis signaling markers. Our findings suggest that androgen deficiency-induced vascular dysfunction is an event involving hypotrophic vascular remodeling of IPAs.
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Affiliation(s)
- Rh Ure Alves-Lopes
- Department of Pharmacology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Karla B Neves
- Department of Pharmacology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil.,Department of Physics and Chemistry, Faculty of Pharmaceutical Sciences of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Marcondes Ab Silva
- Department of Pharmacology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Vânia C Olivon
- Department of Pharmacology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Silvia G Ruginsk
- Department of Physiological Sciences, Biomedical Sciences Institute, Federal University of Alfenas, Alfenas, MG, Brazil.,Department of Physiology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - José Antunes-Rodrigues
- Department of Physiology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Leandra Nz Ramalho
- Department of Pathology and Legal Medicine, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Rita C Tostes
- Department of Pharmacology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Fernando Silva Carneiro
- Department of Pharmacology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil
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Tao M, Tasdemir C, Tasdemir S, Shahabi A, Liu G. Penile alterations at early stage of type 1 diabetes in rats. Int Braz J Urol 2017; 43:753-761. [PMID: 28338308 PMCID: PMC5557453 DOI: 10.1590/s1677-5538.ibju.2016.0454] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Accepted: 11/11/2016] [Indexed: 11/22/2022] Open
Abstract
Objective Diabetes affects the erectile function significantly. However, the penile alterations in the early stage of diabetes in experimental animal models have not been well studied. We examined the changes of the penis and its main erectile components in diabetic rats. Materials and methods Male Sprague-Dawley rats were divided into 2 groups: streptozotocin (STZ)-induced diabetics and age-matched controls. Three or nine weeks after diabetes induction, the penis was removed for immunohistochemical staining of smooth muscle and neuronal nitric oxide synthase (nNOS) in midshaft penile tissues. The cross-sectional areas of the whole midshaft penis and the corpora cavernosa were quantified. The smooth muscle in the corpora cavernosa and nNOS in the dorsal nerves were quantified. Results The weight, but not the length, of the penis was lower in diabetics. The cross-sectional areas of the total midshaft penis and the corpora cavernosa were lower in diabetic rats compared with controls 9 weeks, but not 3 weeks after diabetes induction. The cross-sectional area of smooth muscle in the corpora cavernosa as percentage of the overall area of the corpora cavernosa was lower in diabetic rats than in controls 9 weeks, but not 3 weeks after diabetes induction. Percentage change of nNOS in dorsal nerves was similar at 3 weeks, and has a decreased trend at 9 weeks in diabetic rats compared with controls. Conclusions Diabetes causes temporal alterations in the penis, and the significant changes in STZ rat model begin 3-9 weeks after induction. Further studies on the reversibility of the observed changes are warranted.
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Affiliation(s)
- Mingfang Tao
- Department of Urology, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Cemal Tasdemir
- Department of Urology, Case Western Reserve University School of Medicine, Cleveland, OH, USA.,Department of Urology, Inonu University, Medical Faculty, Malatya, Turkey
| | - Seda Tasdemir
- Department of Urology, Case Western Reserve University School of Medicine, Cleveland, OH, USA.,Department of Pharmacology, Inonu University, Medical Faculty, Malatya, Turkey
| | - Ali Shahabi
- Department of Urology, Case Western Reserve University School of Medicine, Cleveland, OH, USA.,Department of Surgery, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Guiming Liu
- Department of Urology, Case Western Reserve University School of Medicine, Cleveland, OH, USA.,Department of Surgery, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, USA
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Cunha JPD, Lizarte FS, Novais PC, Gattas D, Carvalho CAMD, Tirapelli DPDC, Molina CAF, Tirapelli LF, Tucci S. Expression profiles of eNOS, iNOS and microRNA-27b in the corpus cavernosum of rats submitted to chronic alcoholism and Diabetes mellitus. Acta Cir Bras 2017; 32:38-45. [PMID: 28225916 DOI: 10.1590/s0102-865020170105] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 12/18/2016] [Indexed: 01/23/2023] Open
Abstract
Purpose: To evaluate the expression of endothelial and inducible NOS in addition to the miRNA-27b in the corpus cavernosum and peripheral blood of healthy rats, diabetic rats, alcoholic rats and rats with both pathologies. Methods: Forty eight Wistar rats were divided into four groups: control (C), alcoholic (A), diabetic (D) and alcoholic-diabetic (AD). Samples of the corpus cavernosum were prepared to study protein expressions of eNOS and iNOS by immunohistochemistry and expression of miRNA-27b in the corpus cavernosum and peripheral blood. Results: Immunohistochemistry for eNOS and iNOS showed an increase in cavernosal smooth muscle cells in the alcoholic, diabetic and alcoholic-diabetic groups when compared with the control group. Similarly, the mRNA levels for eNOS were increased in cavernosal smooth muscle (CSM) in the alcoholic, diabetic and alcoholic-diabetic groups and miRNA-27b were decreased in CSM in the alcoholic, diabetic and alcoholic-diabetic groups. Conclusion: The major new finding of our study was an impairment of relaxation of cavernosal smooth muscle in alcoholic, diabetic, and alcoholic-diabetic rats that involved a decrease in the nitric oxide pathway by endothelium-dependent mechanisms accompanied by a change in the corpus cavernosum contractile sensitivity.
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Affiliation(s)
- Joao Paulo da Cunha
- Master, Postgraduate Program in Clinical Surgery, Department of Surgery and Anatomy, School of Medicine of Ribeirao Preto, Universidade de São Paulo (USP), Ribeirao Preto-SP, Brazil. Acquisition and interpretation of data, manuscript writing
| | - Fermino Sanches Lizarte
- Pos-doctoral Fellow student, Postgraduate Program in Clinical Surgery, Department of Surgery and Anatomy, School of Medicine of Ribeirao Preto, USP, Ribeirao Preto-SP, Brazil. Technical procedures, manuscript writing
| | - Paulo Cezar Novais
- Assistant Professor, Department of Health Sciences, Universidade de Marília, Brazil. Technical procedures, manuscript writing
| | - Daniela Gattas
- Fellow Master degree, Postgraduate Program in Clinical Surgery, Department of Surgery and Anatomy, School of Medicine of Ribeirao Preto, USP, Ribeirao Preto-SP, Brazil. Manuscript writing
| | - Camila Albuquerque Mello de Carvalho
- Assistant Professor, Institute of Biological and Health Sciences, Federal University of Alagoas, Alagoas, Brazil and PhD Student, Clinical Surgery Postgraduate Program, Department of Surgery and Anatomy, School of Medicine of Ribeirao Preto, USP, Ribeirao Preto-SP, Brazil. Manuscript writing
| | - Daniela Pretti da Cunha Tirapelli
- Assistant Professor, Department of Surgery and Anatomy, Surgical Clinic Program, School of Medicine of Ribeirao Preto, USP, Ribeirao Preto-SP, Brazil, Scientific and intellectual content of the study
| | - Carlos Augusto Fernandes Molina
- Assistant Professor, Division of Urology, Department of Surgery and Anatomy, School of Medicine of Ribeirao Preto, USP, Ribeirao Preto-SP, Brazil. Scientific and intellectual content of the study
| | - Luis Fernando Tirapelli
- Associate Professor, Department of Surgery and Anatomy, School of Medicine of Ribeirao Preto, USP, Ribeirao Preto-SP, Brazil. Scientific and intellectual content of the study
| | - Silvio Tucci
- Associate Professor, Division of Urology, Department of Surgery and Anatomy, School of Medicine of Ribeirao Preto, USP, Ribeirao Preto-SP, Brazil. Concept, design, intellectual and scientific content of the study; critical revision; supervised all phases of the study
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Chung E. Translating Penile Erectile Hydraulics to Clinical Application in Inflatable Penile Prosthesis Implant. CURRENT SEXUAL HEALTH REPORTS 2017. [DOI: 10.1007/s11930-017-0107-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Wang X, Liu C, Xu Y, Chen P, Shen Y, Xu Y, Zhao Y, Chen W, Zhang X, Ouyang Y, Wang Y, Xie C, Zhou M, Liu C. Combination of mesenchymal stem cell injection with icariin for the treatment of diabetes-associated erectile dysfunction. PLoS One 2017; 12:e0174145. [PMID: 28350842 PMCID: PMC5369760 DOI: 10.1371/journal.pone.0174145] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2016] [Accepted: 02/16/2017] [Indexed: 12/18/2022] Open
Abstract
The present study was aimed to examine whether icariin, a traditional Chinese medicine, could improve therapeutic effects of adipose derived mesenchymal stem cells (ADSCs) for diabetes-associated erectile dysfunction (DMED). DMED were induced in rats by intraperitoneal injection of streptozotocin and confirmed by erectile function measurement. Then, rats of diabetic ED were randomly divided to receive the treatment of saline, ADSCs, icariin or ADSCs combined with icariin respectively. Compared with the treatment by ADSCs or icariin alone, intracavernosum injection of ADSCs combined with the following daily gastric gavage of icariin significantly augmented the value of ICP and ICP/MAP (p<0.01). Meanwhile, the survival of transplanted ADSCs was much improved due to the application of icariin. Similarly, immunofluorescent staining analysis demonstrated that the improved erectile tissue structure by combination of ADSCs and icariin was significantly associated with the increased expression of endothelial markers (vWF) (p<0.01) and smooth muscle markers (α-SMA) (p<0.01). Furthermore, the structure changes in corpus cavernosum were further confirmed by the Masson’s trichrome staining. To explore the possible mechanism underlying icariin-enhanced therapeutic efficacy of MSCs, we employed an in vitro testing system by introducing H2O2 to imitate oxidative stress condition considering the oxidative environment faced by engrafted ADSCs and anti-oxidative capacity of icariin.In vitro, we found that the addition of icariin considerably reduced the apoptosis of ADSCs, and attenuated the intracellular reactive oxygen species (ROS), the superoxidase dismutase (SOD) activity and the lactate dehydrogenase (LDH). Subsequently, we examined the expression of apoptosis-related proteins and explored the potential signaling pathway through which icariin promoted the survival of ADSCs against oxidative stress. It was demonstrated that icariin significantly inhibited the upregulation of apoptosis-related proteins under oxidative condition, including Bax and cleaved caspase-3, while promoted the expression of anti-apoptotic factor BCL2. These effects were accompanied with the activation of signal molecules, PI3K/Akt and STAT3. The further signal protein inhibition assays exhibited that the suppression of STAT3 abrogated the icariin-mediated anti-apoptotic effects observed above, while did not influence the expression of PI3K/Akt. However, PI3K inhibition could abrogate icariin–mediated STAT3 activation and achieved a similar effect as STAT3 inhibition. Our results suggested that icariin was an effective adjuvant for enhancing ADSC-based therapy of DMEM, which may be ascribed to their protection of ADSCs against oxidative stress via the regulation of PI3K/Akt-STAT3 signal pathway.
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Affiliation(s)
- Xiyou Wang
- Department of Urology, PLA Navy General Hospital, Hai dian District, Beijing, People's Republic of China
| | - Chuanhai Liu
- Department of Urology, The Second Artillery General Hospital of Chinese People’s Liberation Army, Xicheng District, Beijing, People's Republic of China
| | - Yong Xu
- Department of Urology, PLA General Hospital, Hai dian District, Beijing, People's Republic of China
| | - Ping Chen
- Department of Urology, PLA Navy General Hospital, Hai dian District, Beijing, People's Republic of China
| | - Yue Shen
- Department of Urology, PLA Navy General Hospital, Hai dian District, Beijing, People's Republic of China
| | - Yansheng Xu
- Department of Urology, PLA Navy General Hospital, Hai dian District, Beijing, People's Republic of China
| | - Yubo Zhao
- Department of Urology, PLA Navy General Hospital, Hai dian District, Beijing, People's Republic of China
| | - Weihao Chen
- Department of Urology, PLA Navy General Hospital, Hai dian District, Beijing, People's Republic of China
| | - Xinyu Zhang
- Department of Urology, PLA Navy General Hospital, Hai dian District, Beijing, People's Republic of China
| | - Yun Ouyang
- Department of Urology, PLA Navy General Hospital, Hai dian District, Beijing, People's Republic of China
| | - Yi Wang
- Department of Urology, PLA Navy General Hospital, Hai dian District, Beijing, People's Republic of China
| | - Changliang Xie
- Department of Urology, PLA Navy General Hospital, Hai dian District, Beijing, People's Republic of China
| | - Maojun Zhou
- Department of Urology, PLA Navy General Hospital, Hai dian District, Beijing, People's Republic of China
| | - Cuilong Liu
- Department of Urology, PLA Navy General Hospital, Hai dian District, Beijing, People's Republic of China
- * E-mail:
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Turkay R, Inci E, Yenice MG, Tugcu V. Shear wave elastography: Can it be a new radiologic approach for the diagnosis of erectile dysfunction? ULTRASOUND : JOURNAL OF THE BRITISH MEDICAL ULTRASOUND SOCIETY 2017; 25:150-155. [PMID: 29410690 DOI: 10.1177/1742271x17697512] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 02/02/2017] [Indexed: 01/12/2023]
Abstract
Introduction Erectile dysfunction (ED) is a common health problem among males, and radiology has limited use in its diagnosis and treatment. Shear wave elastography (SWE) is a new sonographic technique. In this study, we examined the significance of SWE in the diagnosis of ED. Methods The study included a total number of 70 participants. The mean age of the participants was 54.14 ± 8.03 years (range: 39 and 71 years old). We composed two groups. Group 1 had 35 patients who presented to the urology clinic in our hospital complaining of ED, and had a score of 17 or lower from the International Index of Erectile Function (IIEF) questionnaire. Group 2 consisted of 35 healthy volunteers who did not have ED. SWE measurements were performed from corpus cavernosum penis in both groups, and the results were noted. Differences between the groups were evaluated statistically. Results The difference between the mean SWE measurements of two groups (Group 1: 20.94 ± 6.23 kPa and group 2: 24.63 ± 7.58 kPa) was found to be statistically significant (p = 0.027; p < 0.05). For a cut-off value of 17.1 kPa, the SWE method has specificity, sensitivity, positive predictive value, and negative predictive value regarding diagnosis of ED as 94.29%, 34.29%, 85.71%, and 58.93%, respectively. The mean age of the groups did not show a statistically significant difference (p = 0.287; p > 0.05). Conclusions Due to its high specificity and positive predictive value, SWE can offer useful data in the radiologic evaluation of ED cases.
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Kałka D, Karpiński Ł, Gebala J, Rusiecki L, Biełous-Wilk A, Krauz ES, Piłot M, Womperski K, Rusiecka M, Pilecki W. Sexual health of male cardiac patients - present status and expectations of patients with coronary heart disease. Arch Med Sci 2017; 13:302-310. [PMID: 28261282 PMCID: PMC5332461 DOI: 10.5114/aoms.2017.65332] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 04/17/2015] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Due to the pathogenetic association between erectile disorders and cardiovascular diseases, cardiologists consult many patients with erectile dysfunction (ED). The aim of the study was to evaluate sexual function in patients with coronary heart disease (CHD) and the use of sexual knowledge in cardiology practice, both current use and that expected by patients. MATERIAL AND METHODS One thousand one hundred and thirty-six patients (average age: 60.73 ±9.20) underwent a dedicated survey which encompassed demographic data and the presence of modifiable ED risk factors. The presence of ED was assessed using the International Index of Erectile Function (IIEF-5) Questionnaire. RESULTS Sexual problems were discussed by cardiologists with 45 (3.96%) patients. The frequency of initiating the topic was significantly associated with the respondents' education level (p = 0.0031); however, it was not associated with the patients' age, duration of CHD, presence of ED, or modifiable risk factors. Four hundred and sixteen (36.62%) respondents indicated that they expect their cardiologist to take an interest in their ED. Nine hundred and twenty-six (81.51%) patients claimed good sexual function to be important or very important to them. Attitude to sexual function was significantly associated with age (p < 0.0001), duration of CHD (p = 0.0018), education (p = 0.0011), presence of ED (p = 0.0041), diabetes (p = 0.0283) and hyperlipidaemia (p = 0.0014). CONCLUSIONS The low frequency with which cardiologists initiate the topic of ED is in contrast to the expectations of patients with CHD. The majority of these patients regard good sexual maintenance as an important part of their life.
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Affiliation(s)
- Dariusz Kałka
- Cardiosexology Unit, Department of Pathophysiology, Medical University of Wroclaw, Wroclaw, Poland
- Center of Men’s Health, Wroclaw, Poland
| | - Łukasz Karpiński
- Center of Men’s Health, Wroclaw, Poland
- Center of Cardiac Prevention and Rehabilitation CREATOR, Wroclaw, Poland
| | | | - Lesław Rusiecki
- Cardiosexology Unit, Department of Pathophysiology, Medical University of Wroclaw, Wroclaw, Poland
| | - Anna Biełous-Wilk
- Cardiosexology Unit, Department of Pathophysiology, Medical University of Wroclaw, Wroclaw, Poland
| | - Ewa S. Krauz
- Department of Cardiac Rehabilitation, Lower Silesian Heart Diseases Centre “Medinet”, Wroclaw, Poland
| | - Magdalena Piłot
- Department of Cardiac Rehabilitation, Centre of Cardiac Rehabilitation and Cardiac Prevention, Glucholazy, Poland
| | - Krzysztof Womperski
- Department of Cardiac Rehabilitation, Hospital of the Ministry of Interior, Glucholazy, Poland
| | - Małgorzata Rusiecka
- Department of Oncology and Gynaecologic Oncology, Medical University of Wroclaw, Wroclaw, Poland
| | - Witold Pilecki
- Cardiosexology Unit, Department of Pathophysiology, Medical University of Wroclaw, Wroclaw, Poland
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Choi SM, Seo DH, Lee SW, Lee C, Jeh SU, Kam SC, Hwa JS, Chung KH, Hyun JS. The Effect of Alcohol Administration on the Corpus Cavernosum. World J Mens Health 2017; 35:34-42. [PMID: 28064474 PMCID: PMC5419118 DOI: 10.5534/wjmh.2017.35.1.34] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 11/01/2016] [Accepted: 11/14/2016] [Indexed: 11/21/2022] Open
Abstract
Purpose We studied the effects of alcohol administration on the corpus cavernosum (CC) using an animal model. Materials and Methods CC sections and the aortic ring of rabbits were used in an organ bath study. After acute alcohol administration, changes in blood alcohol concentration and electrical stimulation induced intracavernosal pressure/mean arterial pressure (ICP/MAP) percentage were compared in rats. Cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP) levels in the CC were measured using immunoassays. After chronic alcohol administration, ICP/MAP percentage, cAMP and cGMP were compared in rats. Histological changes were examined using the Masson trichrome stain and the Sircol collagen assay. Endothelial nitric oxide synthase (eNOS) expression was examined using immunohistochemistry and Western blotting. Results Alcohol relaxed the CC in a dose-dependent manner, and the relaxation response was suppressed when pretreated with propranolol, indomethacin, glibenclamide, and 4-aminopyridine. In rats with acute alcohol exposure, the cAMP level in the CC was significantly greater than was observed in the control group (p<0.05). In rats with chronic alcohol exposure, however, changes in cAMP and cGMP levels were insignificant, and the CC showed markedly smaller areas of smooth muscle, greater amounts of dense collagen (p<0.05). Immunohistochemical analysis of eNOS showed a less intense response, and western blotting showed that eNOS expression was significantly lower in this group (p<0.05). Conclusions Acute alcohol administration activated the cAMP pathway with positive effects on erectile function. In contrast, chronic alcohol administration changed the ultrastructures of the CC and suppressed eNOS expression, thereby leading to erectile dysfunction.
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Affiliation(s)
- See Min Choi
- Department of Urology, Gyeongsang National University Hospital, Jinju, Korea
| | - Deok Ha Seo
- Department of Urology, Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - Sin Woo Lee
- Department of Urology, Gyeongsang National University Hospital, Jinju, Korea
| | - Chunwoo Lee
- Department of Urology, Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - Seong Uk Jeh
- Department of Urology, Gyeongsang National University Hospital, Jinju, Korea
| | - Sung Chul Kam
- Department of Urology, Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - Jeong Seok Hwa
- Department of Urology, Gyeongsang National University Hospital, Jinju, Korea
| | - Ky Hyun Chung
- Department of Urology, Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - Jae Seog Hyun
- Department of Urology, Gyeongsang National University Hospital, Jinju, Korea
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Pallangyo P, Nicholaus P, Kisenge P, Mayala H, Swai N, Janabi M. A community-based study on prevalence and correlates of erectile dysfunction among Kinondoni District Residents, Dar Es Salaam, Tanzania. Reprod Health 2016; 13:140. [PMID: 27899129 PMCID: PMC5129661 DOI: 10.1186/s12978-016-0249-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 10/20/2016] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Globally, erectile dysfunction burden (ED) is rising appreciably and it is projected to affect about 332 million men by the year 2025. This rise is attributable to the rising incidence of conditions associated with ED including obesity, diabetes, hypertension, coronary artery disease and depression. We conducted this community-based screening to elucidate on the prevalence of ED and its associated factors among men residing in an urban community in Tanzania. METHODS We conducted a cross-sectional community-based study and interviewed 441 men aged at least 18 years. Diabetes and hypertension were defined as per the International Diabetes Federation (IDF) and the 7th Report of the Joint National Committee (JNC 7) respectively. The 5-item version of the International Index of Erectile Function (IIEF-5) Scale was used to assess for erectile dysfunction. Multivariate logistic regression analyses were performed to explore the factors associated with ED. RESULTS The mean age was 47.1 years, 57.6 % had excess body weight, 8.2 % had diabetes and 61.5 % had high blood pressure. Overall, 24 % (106/441) of men in this study had some form of ED. Participants with age ≥55, positive smoking history, obesity, diabetes and hypertension displayed highest rates of ED in their respective subgroups. However, age ≥40 and diabetes were ultimately the strongest factors for ED after multivariate logistic regression analyses, (OR 5.0, 95 % CI 2.2-11.2, p < 0.001 and OR 5.3, 95 % CI 2.2-12.7, p < 0.001 respectively). CONCLUSION Erectile dysfunction affects about a quarter of adult men living in Kinondoni district. Old age, obesity, smoking, hypertension and diabetes have the potential to increase the odds of ED up-to 5 times. In view of this, men with diabetes and hypertension should be offered screening services and treatment of ED as an integral component in their management.
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Affiliation(s)
- Pedro Pallangyo
- Department of Adult Cardiovascular Medicine, Jakaya Kikwete Cardiac Institute, P.O. Box 65141, Dar es Salaam, Tanzania. .,Unit of Research, Jakaya Kikwete Cardiac Institute, P.O. Box 65141, Dar es Salaam, Tanzania.
| | - Paulina Nicholaus
- Department of Adult Cardiovascular Medicine, Jakaya Kikwete Cardiac Institute, P.O. Box 65141, Dar es Salaam, Tanzania
| | - Peter Kisenge
- Department of Adult Cardiovascular Medicine, Jakaya Kikwete Cardiac Institute, P.O. Box 65141, Dar es Salaam, Tanzania
| | - Henry Mayala
- Department of Adult Cardiovascular Medicine, Jakaya Kikwete Cardiac Institute, P.O. Box 65141, Dar es Salaam, Tanzania
| | - Noel Swai
- Department of Adult Cardiovascular Medicine, Jakaya Kikwete Cardiac Institute, P.O. Box 65141, Dar es Salaam, Tanzania
| | - Mohamed Janabi
- Department of Adult Cardiovascular Medicine, Jakaya Kikwete Cardiac Institute, P.O. Box 65141, Dar es Salaam, Tanzania
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Mollace V, Malara N, Gratteri S, Palma E, Zappia L, Costa N, Rosano G, Paone S. Bergamot polyphenolic fraction counteracts erectile dysfunction occurring in patients suffering from type 2 diabetes. PHARMANUTRITION 2016. [DOI: 10.1016/j.phanu.2015.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Effects of the start time of glycemic control on erectile function in streptozotocin-induced diabetic rats. Int J Impot Res 2016; 29:23-29. [PMID: 27654033 DOI: 10.1038/ijir.2016.39] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2015] [Revised: 05/12/2016] [Accepted: 08/01/2016] [Indexed: 12/14/2022]
Abstract
Diabetes-induced ED correlates with diabetes duration and glycemic control. This study evaluated the effect of glycemic control start time on erectile function in streptozotocin-induced diabetic rats. Rats were divided into normal controls (C); untreated diabetic rats (DM); and rats treated after 7 weeks (7W), and 10 weeks (10W) from DM. Treated diabetic rats received a timed daily injection of insulin. After 14 weeks of lab-controlled diabetes, experiments were performed. Group DM showed the ratio of intracavernosal pressure, significantly lower than other groups (10W vs DM; P<0.001). Groups 7W and 10W responded similarly, but did not recover to normal level (group C vs 7W; P<0.001). The percentage of α-smooth muscle actin increased more with earlier start times, and group DM's percentages decreased significantly (group 10W vs DM; P<0.001). Apoptosis recovered significantly only in group 7W, comparable to group C. As start times became earlier, for all molecules (eNOS, Akt, MYPT1 and PECAM-1), treatment groups' results neared those of group C. In conclusion, erectile function of diabetic rats recovered closer to normal controls if diabetic treatment started earlier. And the level of glycemic control was expected to be more important than the start time of diabetic treatment.
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Castela A, Gomes P, Silvestre R, Guardão L, Leite L, Chilro R, Rodrigues I, Vendeira P, Virag R, Costa C. Vasculogenesis and Diabetic Erectile Dysfunction: How Relevant Is Glycemic Control? J Cell Biochem 2016; 118:82-91. [PMID: 27237706 DOI: 10.1002/jcb.25613] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 05/26/2016] [Indexed: 12/16/2022]
Abstract
Erectile dysfunction (ED) is a complication of diabetes, condition responsible for causing endothelial dysfunction (EDys) and hampering repair mechanisms. However, scarce information is available linking vasculogenesis mediated by Endothelial Progenitor Cells (EPCs) and diabetes-associated ED. Furthermore, it remains to be elucidated if glycemic control plays a role on EPCs functions, EPCs modulators, and penile vascular health. We evaluated the effects of diabetes and insulin therapy on bone marrow (BM) and circulating EPCs, testosterone, and systemic/penile Stromal Derived Factor-1 alpha (SDF-1α) expression. Male Wistar rats were divided into groups: age-matched controls, 8-weeks streptozotocin-induced type 1 diabetics, and insulin-treated 8-weeks diabetics. EPCs were identified by flow cytometry for CD34/CD133/VEGFR2/CXCR4 antigens. Systemic SDF-1α and testosterone levels were evaluated by ELISA. Penile SDF-1α protein expression was assessed, in experimental and human diabetic cavernosal samples, by immunohistochemical techniques. Diabetic animals presented a reduction of BM-derived EPCs and an increase in putative circulating endothelial cells (CECs) sloughed from vessels wall. These alterations were rescued by insulin therapy. In addition, glycemic control promoted an increase in systemic testosterone and SDF-1α levels, which were significantly decreased in animals with diabetes. SDF-1α protein expression was reduced in experimental and human cavernosal diabetic samples, an effect prevented by insulin in treated animals. Insulin administration rescued the effects of diabetes on BM function, CECs levels, testosterone, and plasmatic/penile SDF-1α protein expression. This emphasizes the importance of glycemic control in the prevention of diabetes-induced systemic and penile EDys, by the amelioration of endothelial damage, and increase in protective pathways. J. Cell. Biochem. 118: 82-91, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Angela Castela
- Faculty of Medicine, Department of Biochemistry, University of Porto, Porto, Portugal.,Institute for Molecular and Cell Biology of the University of Porto (IBMC-UP), Porto, Portugal.,Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
| | - Pedro Gomes
- Center for Neuroscience and Cell Biology (CNC), University of Coimbra, Coimbra, Portugal
| | - Ricardo Silvestre
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal.,ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Luísa Guardão
- Animal Facility, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Liliana Leite
- Animal Facility, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Rui Chilro
- Digital University, University of Porto, Porto, Portugal
| | - Ilda Rodrigues
- Faculty of Medicine, Department of Biochemistry, University of Porto, Porto, Portugal
| | - Pedro Vendeira
- Clínica Saúde Atlântica, Clínica Urológica Vendeira, Porto, Portugal
| | - Ronald Virag
- Centre d'Explorations et Traitements de l'Impuissance, Paris, France
| | - Carla Costa
- Faculty of Medicine, Department of Biochemistry, University of Porto, Porto, Portugal.,Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
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Alkan E, Ugan RA, Basar MM, Halici Z, Karakus E, Balbay MD, Un H. Role of endothelin receptors and relationship with nitric oxide synthase in impaired erectile response in diabetic rats. Andrologia 2016; 49. [PMID: 27145076 DOI: 10.1111/and.12607] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2016] [Indexed: 12/16/2022] Open
Abstract
To evaluate the protective role of bosentan (BOS), an endothelin-1 (ET-1) receptor antagonist, and to show the changes in rats with experimentally induced diabetic erectile dysfunction (ED), a total of 24 albino Wistar rats were allocated into four groups. Group 1 was the healthy group and Group 2 had diabetes mellitus (DM) induced by intraperitoneal injection of 60 mg kg-1 streptozotocin (STZ). Following the establishment of DM, Group 3 and Group 4 were treated with oral BOS doses of 50 mg kg-1 and 100 mg kg-1 , respectively, for 60 days. At the end of the treatment, we evaluated yawning and erection response to apomorphine treatment and then the animals were sacrificed. ET-1, eNOS, iNOS, tumour necrosis factor (TNF)-α, ET-RA and ET-RB mRNA expressions were analysed in cavernosal tissue. It was observed that yawning and erection response decreased in the diabetic group; however, both of these improved with BOS treatment. While ET-1, TNF-α and iNOS gene expressions increased, eNOS, ET-RA and ET-RB gene expressions decreased in the DM group compared to the healthy group. DM has a negative impact on cavernosal tissue blood flow through activating vasoconstrictor mediators in cavernosal tissue. BOS regulates significantly eNOS, iNOS and TNF-α expressions in a dose-dependent manner.
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Affiliation(s)
- E Alkan
- Department of Urology, Memorial Sisli Hospital, Istanbul, Turkey
| | - R A Ugan
- Faculty of Medicine, Department of Pharmacology, Ataturk University, Erzurum, Turkey
| | - M M Basar
- Department of Urology, Memorial Sisli Hospital, Istanbul, Turkey
| | - Z Halici
- Faculty of Medicine, Department of Pharmacology, Ataturk University, Erzurum, Turkey
| | - E Karakus
- Faculty of Veterinary, Department of Pharmacology and Toxicology, Ataturk University, Erzurum, Turkey
| | - M D Balbay
- Department of Urology, Memorial Sisli Hospital, Istanbul, Turkey
| | - H Un
- Faculty of Pharmacy, Department of Biochemistry, Ibrahim Cecen University, Agri, Turkey
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Abstract
Erectile dysfunction (ED) is a common complication of diabetes, affecting up to 75% of all diabetic men. Although the aetiology of diabetic ED is multifactorial, endothelial dysfunction is recognized as a mainstay in the pathophysiology of the disease. Endothelial dysfunction is induced by the detrimental actions of high glucose levels and increased oxidative stress on endothelial cells that make up the vascular lining. Besides directly injuring the endothelium, diabetes might also hamper vascular repair mechanisms of angiogenesis and vasculogenesis. These states exacerbate and maintain endothelial dysfunction, impairing vasorelaxation events and cavernosal blood perfusion, which are crucial for normal erectile function.
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Canalichio K, Jaber Y, Wang R. Surgery and hormonal treatment for prostate cancer and sexual function. Transl Androl Urol 2016; 4:103-9. [PMID: 26816817 PMCID: PMC4708130 DOI: 10.3978/j.issn.2223-4683.2015.01.13] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Prostate cancer (PC) is one of the most common cancers effecting men today. With earlier detection and improvements in available treatment modalities, there still remains significant morbidity associated with the treatment of PC. Male sexual health and erectile function are greatly impacted by these therapies and remain a concern to PC survivors. This article reviews the current literature on male sexual health following radical prostatectomy (RP) or androgen ablation therapy for PC. Each treatment modality affects male sexual function to an appreciable level, although certain patients have better outcomes if they have preoperative potency, are younger, or have nerve-sparing surgery. There is a delayed recovery up to 2 years seen in erectile function following RP. With androgen deprivation therapy (ADT), attempts can be made at different administration strategies and exercise may possibly play a role in maintaining erectile function. Penile rehabilitation protocols attempt to protect erectile function immediately following therapy through different modalities, although no one approach has been agreed upon.
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Affiliation(s)
- Katie Canalichio
- 1 Division of Urology, University of Texas Health Science Center, Houston, TX 77030, USA ; 2 Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Yasmeen Jaber
- 1 Division of Urology, University of Texas Health Science Center, Houston, TX 77030, USA ; 2 Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Run Wang
- 1 Division of Urology, University of Texas Health Science Center, Houston, TX 77030, USA ; 2 Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
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Abstract
BACKGROUND Erectile dysfunction (ED) is a common disorder in man that influences the quality of life of the patient and his partner. Known risk factors for ED comprise diabetes, coronary artery disease, hypertension but also lifestyle modifications such as smoking, diminished physical activity as well as obesity. In this manuscript the current scientific literature about genetics and erectile dysfunction is reviewed. MATERIALS AND METHODS A literature search using the databank PubMed covering the topics genetics and erectile dysfunction was performed and relevant papers selected for presentation. RESULTS Several aspects of genetics and ED are described in the current literature. Association studies of candidate polymorphisms and ED risk in comparison to healthy controls is a major area of research. Another topic is the genome-wide search for candidate polymorphisms with erectile dysfunction. The paper closes with the presentation of the pharmacogenomic analysis of treatment response to phosphodiesterase-5 inhibitors. DISCUSSION The heterogeneous results of genetic association studies are possibly due to small sample sizes of the study population and/or due to ethnic differences of the analyzed populations. This underlines the need for validation of this data in larger prospective multinational multicenter studies.
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Affiliation(s)
- A Eisenhardt
- Praxisklinik Urologie Rhein Ruhr, Schulstr. 11, 45468, Mülheim an der Ruhr, Deutschland,
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Castela A, Gomes P, Domingues VF, Paíga P, Costa R, Vendeira P, Costa C. Role of oxidative stress-induced systemic and cavernosal molecular alterations in the progression of diabetic erectile dysfunction. J Diabetes 2015; 7:393-401. [PMID: 24910190 DOI: 10.1111/1753-0407.12181] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Revised: 05/13/2014] [Accepted: 06/01/2014] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Erectile dysfunction (ED) is a prevalent complication of diabetes, and oxidative stress is an important feature of diabetic ED. Oxidative stress-induced damage plays a pivotal role in the development of tissue alterations. However, the deleterious effects of oxidative stress in the corpus cavernosum with the progression of diabetes remain unclear. The aim of this study was to evaluate systemic and penile oxidative stress status in the early and late stages of diabetes. METHODS Male Wistar streptozotocin-diabetic rats (and age-matched controls) were examined 2 (early) and 8 weeks (late) after the induction of diabetes. Systemic oxidative stress was evaluated by urinary H2 O2 and the ratio of circulating reduced/oxidized glutathione (GSH/GSSG). Penile oxidative status was assessed by H2 O2 production and 3-nitrotyrosine (3-NT) formation. Cavernosal endothelial nitric oxide synthase (eNOS) was analyzed by quantitative immunohistochemistry. Dual immunofluorescence was also performed for 3-NT and α-smooth muscle actin (α-SMA) and eNOS-α-SMA. RESULTS There was a significant increase in urinary H2 O2 levels in both diabetic groups. The plasma GSH/GSSG ratio was significantly augmented in late diabetes. In cavernosal tissue, H2 O2 production was significantly increased in late diabetes. Reactivity for 3-NT was located predominantly in cavernosal smooth muscle (SM) and was significantly reduced in late diabetes. Quantitative immunohistochemistry revealed a significant decrease in eNOS levels in cavernosal SM and endothelium in late diabetes. CONCLUSIONS The findings indicate that the noxious effects of oxidative stress are more prominent in late diabetes. Increased penile protein oxidative modifications and decreased eNOS expression may be responsible for structural and/or functional deregulation, contributing to the progression of diabetes-associated ED.
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Affiliation(s)
- Angela Castela
- Department of Biochemistry (U38/FCT), Center for Medical Research, Faculty of Medicine of the University of Porto, Porto, Portugal; Institute for Molecular and Cell Biology of the University of Porto (IBMC-UP), Porto, Portugal
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Wang X, Liu C, Li S, Xu Y, Chen P, Liu Y, Ding Q, Wahafu W, Hong B, Yang M. Hypoxia precondition promotes adipose-derived mesenchymal stem cells based repair of diabetic erectile dysfunction via augmenting angiogenesis and neuroprotection. PLoS One 2015; 10:e0118951. [PMID: 25790284 PMCID: PMC4366267 DOI: 10.1371/journal.pone.0118951] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2014] [Accepted: 01/20/2015] [Indexed: 12/16/2022] Open
Abstract
The aim of the present study was to examine whether hypoxia preconditioning could improve therapeutic effects of adipose derived mesenchymal stem cells (AMSCs) for diabetes induced erectile dysfunction (DED). AMSCs were pretreated with normoxia (20% O2, N-AMSCs) or sub-lethal hypoxia (1% O2, H-AMSCs). The hypoxia exposure up-regulated the expression of several angiogenesis and neuroprotection related cytokines in AMSCs, including vascular endothelial growth factor (VEGF) and its receptor FIK-1, angiotensin (Ang-1), basic fibroblast growth factor (bFGF), brain-derived neurotrophic factor (BDNF), glial cell-derived neurotrophic factor (GDNF), stromal derived factor-1 (SDF-1) and its CXC chemokine receptor 4 (CXCR4). DED rats were induced via intraperitoneal injection of streptozotocin (60 mg/kg) and were randomly divided into three groups—Saline group: intracavernous injection with phosphate buffer saline; N-AMSCs group: N-AMSCs injection; H-AMSCs group: H-AMSCs injection. Ten rats without any treatment were used as normal control. Four weeks after injection, the mean arterial pressure (MAP) and intracavernosal pressure (ICP) were measured. The contents of endothelial, smooth muscle, dorsal nerve in cavernoursal tissue were assessed. Compared with N-AMSCs and saline, intracavernosum injection of H-AMSCs significantly raised ICP and ICP/MAP (p<0.05). Immunofluorescent staining analysis demonstrated that improved erectile function by MSCs was significantly associated with increased expression of endothelial markers (CD31 and vWF) (p<0.01) and smooth muscle markers (α-SMA) (p<0.01). Meanwhile, the expression of nNOS was also significantly higher in rats receiving H-AMSCs injection than those receiving N-AMSCs or saline injection. The results suggested that hypoxic preconditioning of MSCs was an effective approach to enhance their therapeutic effect for DED, which may be due to their augmented angiogenesis and neuroprotection.
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Affiliation(s)
- XiYou Wang
- Department of Traditional Chinese Medicine, Chinese People’s Liberation Army General Hospital, No 28 Fuxing Road, Hai dian District, Beijing 100853, People’s Republic of China
| | - CuiLong Liu
- Department of Urology, PLA Navy General Hospital, No 6 Fucheng Road, Hai dian District, Beijing 100048, People’s Republic of China
| | - ShaoDan Li
- Department of Traditional Chinese Medicine, Chinese People’s Liberation Army General Hospital, No 28 Fuxing Road, Hai dian District, Beijing 100853, People’s Republic of China
| | - Yong Xu
- Department of Urology, Chinese People’s Liberation Army General Hospital, No 28 Fuxing Road, Hai dian District, Beijing 100853, People’s Republic of China
| | - Ping Chen
- Department of Urology, Chinese People’s Liberation Army General Hospital, No 28 Fuxing Road, Hai dian District, Beijing 100853, People’s Republic of China
| | - Yi Liu
- Department of Traditional Chinese Medicine, Chinese People’s Liberation Army General Hospital, No 28 Fuxing Road, Hai dian District, Beijing 100853, People’s Republic of China
| | - Qiang Ding
- Department of Urology, Chinese People’s Liberation Army General Hospital, No 28 Fuxing Road, Hai dian District, Beijing 100853, People’s Republic of China
| | - Wasilijiang Wahafu
- Department of Urology, Chinese People’s Liberation Army General Hospital, No 28 Fuxing Road, Hai dian District, Beijing 100853, People’s Republic of China
| | - BaoFa Hong
- Department of Urology, Chinese People’s Liberation Army General Hospital, No 28 Fuxing Road, Hai dian District, Beijing 100853, People’s Republic of China
| | - MingHui Yang
- Department of Traditional Chinese Medicine, Chinese People’s Liberation Army General Hospital, No 28 Fuxing Road, Hai dian District, Beijing 100853, People’s Republic of China
- * E-mail:
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Choi WS, Kwon OS, Cho SY, Paick J, Kim SW. Effect of Chronic Administration of PDE5 Combined with Glycemic Control on Erectile Function in Streptozotocin‐Induced Diabetic Rats. J Sex Med 2015; 12:600-10. [DOI: 10.1111/jsm.12752] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Leoni LAB, Fukushima AR, Rocha LY, Maifrino LBMM, Rodrigues B. Physical activity on endothelial and erectile dysfunction: a literature review. Aging Male 2014; 17:125-30. [PMID: 24894579 DOI: 10.3109/13685538.2014.923836] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Physical inactivity, diabetes, hypertension, dyslipidemia, smoking and obesity were associated with imbalance in oxidative stress, leading to endothelial dysfunction. Such dysfunction is present in both cardiovascular disease (CVD) and erectile dysfunction (ED). ED is the persistent inability to achieve or sustain an erection sufficient for satisfactory sexual performance and is one of the first manifestations of endothelial damage in men with CVD risk factors. The purpose of this article is to review the results of studies involving physical activity, CVD, endothelial dysfunction and ED in order to verify its applicability for improving the health and quality of life of men with such disorders. There is consistent evidence that endothelial damage is intimately linked to ED, and this manifestation seems to be associated with the appearance CVDs. On the other hand, physical activity has been pointed out as an important clinical strategy in the prevention and treatment of CVDs and ED mainly associated with improvement of endothelial function. However, further experimental and clinical prospective investigations are needed to test the role of physical exercises in the modulation of endothelial function and their implications on erectile function and the appearance of CVDs.
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Affiliation(s)
- Luís Antônio B Leoni
- Human Movement Laboratory, São Judas Tadeu University (USJT) , São Paulo , Brazil
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Lockhat Y, Ross A, Ramlachan P, Rangiah C. The prevalence of erectile dysfunction at a primary healthcare clinic in Durban, KwaZulu-Natal. S Afr Fam Pract (2004) 2014. [DOI: 10.1080/20786204.2013.10874352] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Affiliation(s)
| | - A Ross
- Department of Family Medicine, University of KwaZulu-Natal
| | | | - C Rangiah
- Department of Family Medicine, University of KwaZulu Natal
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The connection between type 2 diabetes and erectile dysfunction in Taiwanese aboriginal males. Int J Impot Res 2014; 26:235-40. [DOI: 10.1038/ijir.2014.26] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2013] [Revised: 06/03/2014] [Accepted: 06/13/2014] [Indexed: 12/15/2022]
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50
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Corazza O, Martinotti G, Santacroce R, Chillemi E, Di Giannantonio M, Schifano F, Cellek S. Sexual enhancement products for sale online: raising awareness of the psychoactive effects of yohimbine, maca, horny goat weed, and Ginkgo biloba. BIOMED RESEARCH INTERNATIONAL 2014; 2014:841798. [PMID: 25025070 PMCID: PMC4082836 DOI: 10.1155/2014/841798] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Revised: 05/23/2014] [Accepted: 05/26/2014] [Indexed: 11/17/2022]
Abstract
INTRODUCTION The use of unlicensed food and herbal supplements to enhance sexual functions is drastically increasing. This phenomenon, combined with the availability of these products over the Internet, represents a challenge from a clinical and a public health perspective. METHODS A comprehensive multilingual assessment of websites, drug fora, and other online resources was carried out between February and July 2013 with exploratory qualitative searches including 203 websites. Additional searches were conducted using the Global Public Health Intelligence Network (GPHIN). Once the active constitutes of the products were identified, a comprehensive literature search was carried out using PsycInfo and PubMed. RESULTS The most common sexual enhancement products available on the Internet were identified. Their active ingredients included yohimbine, maca, horny goat weed and Ginkgo biloba. These four substances were reported with the occurrence of adverse events and the induction of psychological symptoms, such as mood changes, anxiety, and hallucinations as well as addictive behaviours. CONCLUSIONS Uncontrolled availability of sexual enhancement products that contain potentially harmful substances is a major public health concern. The possible impact on population health, particularly among subjects with psychiatric disorders, usually at risk for sexual dysfunction, may be significant. This new trend needs to be extensively studied and monitored.
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Affiliation(s)
- Ornella Corazza
- School of Life and Medical Sciences, University of Hertfordshire, College Lane, Hatfield AL10 9AB, UK
| | - Giovanni Martinotti
- Department of Neuroscience and Imaging, University “G. d'Annunzio”, 66100 Chieti, Italy
| | - Rita Santacroce
- School of Life and Medical Sciences, University of Hertfordshire, College Lane, Hatfield AL10 9AB, UK
- Department of Neuroscience and Imaging, University “G. d'Annunzio”, 66100 Chieti, Italy
| | - Eleonora Chillemi
- Department of Neuroscience and Imaging, University “G. d'Annunzio”, 66100 Chieti, Italy
| | | | - Fabrizio Schifano
- School of Life and Medical Sciences, University of Hertfordshire, College Lane, Hatfield AL10 9AB, UK
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