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Prieto LR, Shires DA, Xiong Y. Factors Associated with Erectile Dysfunction Among Older Gay Men. ARCHIVES OF SEXUAL BEHAVIOR 2024:10.1007/s10508-024-02908-3. [PMID: 38839704 DOI: 10.1007/s10508-024-02908-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 04/10/2024] [Accepted: 05/21/2024] [Indexed: 06/07/2024]
Abstract
Erectile dysfunction (ED) is a common issue that aging men encounter, but whether internalized gay ageism (i.e., the internalization of ageist messages within the context of aging as a gay man) is related to ED among older gay men is unknown. A cross-sectional web-based survey explored the relationship between internalized gay ageism, health-related and social factors, and ED among older gay men who resided in the Midwest United States (N = 181). Internalized gay ageism was not significantly associated with ED. However, hierarchical regression analysis found that age (β = .224, t = 2.70, p = .008) and overall health (β = -.247, t = -3.05, p = .003) were significantly associated with ED among older gay men, suggesting that older gay men share similar risk factors for ED as the general male population. Future research should continue to explore other factors that are unique to gay men that may be associated with ED.
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Affiliation(s)
- Lucas R Prieto
- Department of Social Work, College of Public Health, George Mason University, Fairfax, VA, 22030, USA.
| | - Deirdre A Shires
- School of Social Work, Michigan State University, East Lansing, MI, USA
| | - Yuan Xiong
- School of Social Work, Michigan State University, East Lansing, MI, USA
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Aguiar JA, Greenberg DR, Brannigan RE, Halpern JA, Dubin JM. Beyond the prescription: trends and challenges in erectile dysfunction medications among young adult men. Int J Impot Res 2024:10.1038/s41443-024-00902-w. [PMID: 38831015 DOI: 10.1038/s41443-024-00902-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 03/29/2024] [Accepted: 05/03/2024] [Indexed: 06/05/2024]
Abstract
We sought to assess erectile dysfunction (ED) medication use among males aged 18-40. Between June and July 2023, a cross-sectional survey on Qualtrics (Provo, UT) was disseminated via Research Match. Among 210 respondents, ED prevalence was 57.1% with 39.0% reporting prior ED medication use. Black or African American race (OR = 3.54, p < 0.001), Hispanic or Latino ethnicity (OR = 3.32, p = 0.01), and Medicare or Medicaid insurance status (OR = 6.07, p < 0.001) were associated with increased medication utilization. Income >$200,000 was associated with decreased medication usage (OR 0.23, p = 0.04). ED severity significantly correlated with higher medication usage. Primary care providers were the most common source of acquisition (47.6%), followed by online direct to consumer (DTC) platforms (31.7%) and personal connections (19.5%). Privacy (n = 51, 62.2%) and cost (n = 45, 54.9%) were key considerations in obtaining medications. Despite 73.2% of individuals receiving counseling regarding risks/benefits and 84.1% receiving instructions for proper use, only 28.0% correctly identified essential aspects of proper/appropriate use. Overall, we found a high ED prevalence and medication utilization rate. The preference for privacy in procuring medications suggests ongoing stigma around men's sexual health. Despite extensive counseling, a significant knowledge gap remains indicating a pressing need for enhanced patient education.
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Affiliation(s)
- Jonathan A Aguiar
- Department of Urology, Northwestern University, Feinberg School of Medicine, Chicago, IL, 60611, USA.
| | - Daniel R Greenberg
- Department of Urology, Northwestern University, Feinberg School of Medicine, Chicago, IL, 60611, USA
| | - Robert E Brannigan
- Department of Urology, Northwestern University, Feinberg School of Medicine, Chicago, IL, 60611, USA
| | - Joshua A Halpern
- Department of Urology, Northwestern University, Feinberg School of Medicine, Chicago, IL, 60611, USA
| | - Justin M Dubin
- Department of Urology, Memorial Healthcare System, Aventura, FL, 33180, USA
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Ke M, Bao B, Ke Z, Ma W, Guo J, Zhang L, Wen H, Ma L, Fan G, Liu B. The association between lipid parameters and erectile dysfunction: a two-sample Mendelian randomization and case-control study. Endocrine 2024; 84:903-913. [PMID: 38153603 DOI: 10.1007/s12020-023-03653-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 12/04/2023] [Indexed: 12/29/2023]
Abstract
PURPOSE Lipid parameters have been shown to have significant predictive value for cardiovascular disease, but few studies have evaluated their correlation with erectile dysfunction (ED) in young men. METHODS The case-control study encompassed 186 young ED patients (ages 20-40) and 186 healthy controls. Lipid parameters, including total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), TC/HDL ratio, TG/HDL ratio, and LDL-C/HDL-C ratio, were assessed in all participants. The International Index of Erectile Function (IIEF-5) scores were collected for all participants to evaluate erectile status. Multivariate logistic regression analysis was utilized to appraise the association of lipid-related parameters with ED. Single-nucleotide polymorphisms (SNPs) significantly correlated with lipid parameters (TC, TG, LDL-C, HDL-C) were selected from genome-wide association studies (GWAS) as instrumental variables (IV) (P < 5.0 × 10-8). Summary data for ED was gathered from a GWAS with a sample size of (n = 17,353 cases/28,210 controls). The inverse variance weighted (IVW) method was employed as the primary mendelian randomization (MR) analysis method to assess causal effects. Causal estimates were represented as odds ratios (OR) with 95% confidence intervals (CI). RESULTS Results from the case-control study revealed that, when compared with the control group, levels of LDL-C, TG, UA, LDL-C/HDL-C, TG/HDL-C, and TC/HDL-C in the ED group were significantly elevated (P < 0.01), while HDL-C was significantly decreased (P < 0.01) in the ED group. Multivariate logistic regression analysis indicated LDL-C/HDL-C as a risk factor for both the incidence and severity of ED (P < 0.001). Two-sample MR analysis demonstrated no significant causal correlation between lipid parameters-LDL-C (OR, 0.98, 95% CI, 0.88-1.08, P = 0.616), HDL-C (OR, 1.07, 95% CI: 0.96-1.19, P = 0.249), TC (OR, 1.07, 95% CI, 0.96-1.18, P = 0.208), TG (OR, 0.98, 95% CI, 0.80-1.13, P = 0.579) -and an increased risk of ED (all P > 0.05). CONCLUSIONS The case-control analysis ascertained a significant association between LDL-C, HDL-C, LDL-C/HDL-C, and ED and its severity. However, results from the MR study do not support a causal role of lipid parameters in ED.
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Affiliation(s)
- Minghui Ke
- Department of Andrology, China-Japan Friendship Hospital, Beijing, China
| | - Binghao Bao
- Department of Andrology, China-Japan Friendship Hospital, Beijing, China
- Graduate School of Beijing University of Chinese Medicine, Beijing, China
| | - Zhenghao Ke
- Department of Andrology, China-Japan Friendship Hospital, Beijing, China
| | - Wenjing Ma
- Graduate School of Beijing University of Chinese Medicine, Beijing, China
| | - Jianqiang Guo
- Graduate School of Beijing University of Chinese Medicine, Beijing, China
| | - Lei Zhang
- Graduate School of Beijing University of Chinese Medicine, Beijing, China
| | - Haolang Wen
- Graduate School of Beijing University of Chinese Medicine, Beijing, China
| | - Lirong Ma
- Beijing Chaoyang District Hospital of Traditional Chinese Medicine, Beijing, China.
| | - Guohui Fan
- Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing, China.
| | - Baoxing Liu
- Department of Andrology, China-Japan Friendship Hospital, Beijing, China.
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Adesanya O, Rojanasarot S, McGovern AM, Burnett AL. Racial and socioeconomic disparities in surgical care for post-prostate cancer treatment complications: A nationwide Medicare-based analysis. BJUI COMPASS 2024; 5:564-575. [PMID: 38873355 PMCID: PMC11168770 DOI: 10.1002/bco2.342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 02/04/2024] [Indexed: 06/15/2024] Open
Abstract
Objectives To investigate the racial and socioeconomic (income) differences in receipt of and time to surgical care for urinary incontinence (UI) and erectile dysfunction (ED) occurring post-radical prostatectomy (RP) and/or radiation therapy (RT). Materials and Methods Utilizing the Medicare Standard Analytical Files (SAF), a retrospective cohort study was performed on data of patients diagnosed with prostate cancer (PCa) from 2015 to 2021. Patients who underwent RP and/or RT and who subsequently developed UI and/or ED were grouped into four cohorts: RP-ED, RP-UI, RT-ED and RT-UI. County-level median household income was cross-referenced with SAF county codes, classified into income quartiles, and used as a proxy for patient income status. The rate of surgical care was compared between groups using two-sample t-test and log-rank test. Cox proportional hazards modelling was used to determine covariate-adjusted impact of race on time to surgical care. Results The rate of surgical care was 6.8, 3.61 3.07, and 1.54 per 100 person-years for the RP-UI, RT-UI, RP-ED, and RT-ED cohorts, respectively. Cox proportional 'time-to-surgical care' regression analysis revealed that Black men were statistically more likely to receive ED surgical care (RP-ED AHR:1.79, 95% CI:1.49-2.17; RT-ED AHR:1.50, 95% CI:1.11-2.01), but less likely to receive UI surgical care (RP-UI AHR:0.80, 95% CI:0.67-0.96) than White men, in all cohorts except RT-UI. Surgical care was highest among Q1 (lowest income quartile) patients in all cohorts except RT-UI. Conclusions Surgical care for post-PCa treatment complications is low, and significantly impacted by racial and socioeconomic (income) differences. Prospective studies investigating the basis of these results would be insightful.
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Affiliation(s)
- Oluwafolajimi Adesanya
- Department of Urology, James Buchanan Brady Urological InstituteJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | | | | | - Arthur L. Burnett
- Department of Urology, James Buchanan Brady Urological InstituteJohns Hopkins University School of MedicineBaltimoreMarylandUSA
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Mark KP, Arenella K, Girard A, Herbenick D, Fu J, Coleman E. Erectile dysfunction prevalence in the United States: report from the 2021 National Survey of Sexual Wellbeing. J Sex Med 2024; 21:296-303. [PMID: 38410029 DOI: 10.1093/jsxmed/qdae008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 12/04/2023] [Accepted: 01/05/2024] [Indexed: 02/28/2024]
Abstract
BACKGROUND There has been a great deal of public speculation regarding a surge in erectile dysfunction (ED) in younger men despite data consistently indicating that the ED prevalence rates increase with age. AIM In this study we sought to assess the prevalence and risk of experiencing ED in a nationally representative sample of men in the United States across various social groups, describe comorbidities, and examine barriers to treatment. METHODS Data from the 2021 National Survey of Sexual Wellbeing were analyzed by utilizing the Ipsos KnowledgePanel®, a probability-based online panel, for the purpose of obtaining US nationally representative data of adults aged 18 years and older. The analytic sample consisted of 1822 cisgender men ranging in age from 18 to 87 years, with a mean age of 47.5 years. OUTCOMES Study outcomes were ED as measured by the 5-item version of the International Index of Erectile Function (IIEF-5), as well as self-reported diagnosis by a medical professional, comorbidities with other health issues, medications taken for ED, and barriers to treatment. RESULTS The ED prevalence rate based on IIEF-5 scores was 24.2%. Prevalence increased with age: 52.2% of the 75+ age group, and 48.0% of the 65-74 age group meeting diagnostic criteria for ED. Diagnostic criteria were met for more participants in the 18-24 age group (17.9%) than the 25-34 (13.3%) or 35-44 (12.7%) age groups, but less than the 45-54 (25.3%) or 55-64 (33.9%) age groups. Only 7.7% (n = 141) of the sample reported having been diagnosed by a provider (n = 4 in 25-34, n = 6 in 35-44, n = 13 in 45-54, n = 39 in 55-64, n = 44 in 65-74, and n = 34 in ≥75-year olds), indicating a gap in access to treatment. The most common reason selected for not accessing care for ED concerns was a lack of need to see a provider in the past year. CLINICAL IMPLICATIONS The discrepancy between ED self-report and medical diagnosis is critical, given that ED can be an indication of underlying health risks. STRENGTHS AND LIMITATIONS This study is the first nationally representative update to information regarding the prevalence of ED in almost 2 decades. Standard administration of the IIEF-5 is limited to participants who have had sex in the last 6 months, so these rates do not include those men with ED who have been avoiding penetrative sex for a significant time. CONCLUSION The results indicate that ED prevalence and severity remain highest in older age groups and that most individuals who meet criteria for ED have not sought medical care related to this concern.
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Affiliation(s)
- Kristen P Mark
- Institute for Sexual & Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN 55454, United States
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN 55454, United States
| | - Kat Arenella
- California School of Professional Psychology, Alliant International University, Los Angeles, CA 91803, United States
| | - Abby Girard
- Institute for Sexual & Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN 55454, United States
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN 55454, United States
| | - Debby Herbenick
- Department of Applied Health Science, Indiana University School of Public Health, Bloomington, IN 47405, United States
- The Center for Sexual Health Promotion, Indiana University School of Public Health, Indiana University, Bloomington, IN 47405, United States
| | - Jane Fu
- Department of Applied Health Science, Indiana University School of Public Health, Bloomington, IN 47405, United States
- The Center for Sexual Health Promotion, Indiana University School of Public Health, Indiana University, Bloomington, IN 47405, United States
| | - Eli Coleman
- Institute for Sexual & Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN 55454, United States
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN 55454, United States
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Du XL, Martinez J, Yamal JM, Simpson LM, Davis BR. The 18-year risk of cancer, angioedema, insomnia, depression, and erectile dysfunction in association with antihypertensive drugs: post-trial analyses from ALLHAT-Medicare linked data. Front Cardiovasc Med 2023; 10:1272385. [PMID: 38045916 PMCID: PMC10691487 DOI: 10.3389/fcvm.2023.1272385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 10/31/2023] [Indexed: 12/05/2023] Open
Abstract
Purpose This study aimed to determine the 18-year risk of cancer, angioedema, insomnia, depression, and erectile dysfunction in association with antihypertensive drug use. Methods This is a post-trial passive follow-up study of Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) participants between 1994 and 1998 that was conducted by linking their follow-up data with Medicare claims data until 2017 of subjects who were free of outcomes at baseline on 1 January 1999. The main outcomes were the occurrence of cancer (among n = 17,332), angioedema (among n = 17,340), insomnia (among n = 17,340), depression (among n = 17,330), and erectile dysfunction (among n = 7,444 men) over 18 years of follow-up. Results The 18-year cumulative incidence rate of cancer other than non-melanoma skin cancer from Medicare inpatient claims was 23.9% for chlorthalidone, 23.4% for amlodipine, and 25.3% for lisinopril. There were no statistically significant differences in the 18-year risk of cancer, depression, and erectile dysfunction among the three drugs based on the adjusted hazard ratios. The adjusted 18-year risk of angioedema was elevated in those receiving lisinopril than in those receiving amlodipine (hazard ratio: 1.63, 95% CI: 1.14-2.33) or in those receiving chlorthalidone (1.33, 1.00-1.79), whereas the adjusted 18-year risk of insomnia was statistically significantly decreased in those receiving lisinopril than in those receiving amlodipine (0.90, 0.81-1.00). Conclusions The 18-year risk of angioedema was significantly higher in patients receiving lisinopril than in those receiving amlodipine or chlorthalidone; the risk of insomnia was significantly lower in patients receiving lisinopril than in those receiving amlodipine; and the risk of cancer, depression, and erectile dysfunction (in men) was not statistically significantly different among the three drug groups.
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Affiliation(s)
- Xianglin L. Du
- Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Journey Martinez
- Department of Biostatistics and Data Science, Coordinating Center for Clinical Trials, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Jose-Miguel Yamal
- Department of Biostatistics and Data Science, Coordinating Center for Clinical Trials, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Lara M. Simpson
- Department of Biostatistics and Data Science, Coordinating Center for Clinical Trials, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Barry R. Davis
- Department of Biostatistics and Data Science, Coordinating Center for Clinical Trials, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, United States
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Vance G, Zeigler-Hill V, Meehan MM, Young G, Shackelford TK. Erectile Dysfunction, Suspicious Jealousy, and Partner-Directed Behaviors in Heterosexual Romantic Couples. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:3139-3153. [PMID: 37537426 DOI: 10.1007/s10508-023-02672-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 07/03/2023] [Accepted: 07/20/2023] [Indexed: 08/05/2023]
Abstract
Erectile dysfunction (ED) can have negative consequences for men and their intimate partners. The purpose of the present research was to replicate and extend the results of previous studies concerning the connections that ED has with partner-directed behaviors using a sample of heterosexual romantic couples. Specifically, we used an actor-partner interdependence mediation model to examine whether the associations that ED had with men's mate retention behaviors, partner-directed insults, partner-directed violence, and partner-inflicted injuries were mediated by suspicious jealousy, but not reactive jealousy. These associations were examined in 113 romantic couples, using men's self-reports, and partner-reports provided by their female partners. Results indicated that suspicious jealousy (but not reactive jealousy) mediated the associations that ED had with men's use of partner-directed behaviors, such that higher levels of ED were associated with men experiencing more suspicious jealousy, which, in turn, was associated with more cost-inflicting mate retention behaviors, benefit-provisioning mate retention behaviors, partner-directed insults, partner-directed violence, and partner-inflicted injury. However, there were some discrepancies between the reports provided by men and women such that these associations emerged more consistently in the partner-reports provided by women than in the self-reports provided by men. Discussion addresses evolutionary implications of these findings, as well as limitations of this research and directions for research concerning ED.
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Affiliation(s)
- Gavin Vance
- Center for Evolutionary Psychological Science, Department of Psychology, Oakland University, Rochester, MI, 48309, USA.
| | - Virgil Zeigler-Hill
- Center for Evolutionary Psychological Science, Department of Psychology, Oakland University, Rochester, MI, 48309, USA
| | - Madeleine M Meehan
- Center for Evolutionary Psychological Science, Department of Psychology, Oakland University, Rochester, MI, 48309, USA
| | - Gracynn Young
- Center for Evolutionary Psychological Science, Department of Psychology, Oakland University, Rochester, MI, 48309, USA
| | - Todd K Shackelford
- Center for Evolutionary Psychological Science, Department of Psychology, Oakland University, Rochester, MI, 48309, USA
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Lee J, Kim HR, Heo JE, Jang WS, Lee KS, Kang SK, Han H, Choi YD. Phosphodiesterase-5 Inhibitor Use in Robot Assisted Radical Prostatectomy Patients Is Associated with Reduced Risk of Death: A Propensity Score Matched Analysis of 1,058 Patients. World J Mens Health 2023; 41:892-899. [PMID: 36649919 PMCID: PMC10523119 DOI: 10.5534/wjmh.220063] [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: 04/02/2022] [Revised: 10/03/2022] [Accepted: 10/14/2022] [Indexed: 01/18/2023] Open
Abstract
PURPOSE We investigated whether the use of a phosphodiesterase-5 inhibitor (PDE5i) after robot assited radical prostatectomy has a survival benefit over non-use patients because there are controversial results on the association between PDE5i use and survival outcomes for prostate cancer patients in literature. MATERIALS AND METHODS We designed a retrospective, matched, large-sample cohort study of 5,545 patients who underwent robot assisted radical prostatectomy (RARP) during 2013-2021 in a single institute. The exclusion criteria was patients who were aged >70 years at surgery, American Society of Anesthesiologists (ASA) physical status classification grade 4 or 5, history of other malignancies, patients who started PDE5i 6 months after survery and patients with follow up period less than 24 months after surgery. Among the 1,843 included patients, 1,298 were PDE5i users, and 545 were PDE5i non-users. We performed propensity score matching (PSM) of PDE5i users (n=529) with non-users (n=529) by adjusting for the variables of age, Gleason grade group, pathological T stage, preoperative ASA physical status grade, and International Index of Erectile Function score. RESULTS There were no significant difference in patient characteristics according to PSM. Kaplan-Meier curve revealed the difference of overall survival for PDE5i users and non-users (clustered log-rank test p<0.05). In a stratified Cox regression analysis, PDE5i use after RARP was associated with improved overall survival and reduced risk of death (hazard ratio 0.43; confidence interval 0.24-0.79; p=0.007). The limitation of this study was that the indication for the prescription of PDE5i was not given. CONCLUSIONS PDE5i administration after RARP were associated with overall survival of patients with prostate cancer. A further randomized control trial may reveal whether routine use of PDE5i after prostatectomy can improve survival of prostate cancer patient.
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Affiliation(s)
- Jongsoo Lee
- Department of Urology, Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Hye Rim Kim
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Korea
| | - Ji Eun Heo
- Department of Urology, Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Won Sik Jang
- Department of Urology, Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Kwang Suk Lee
- Department of Urology, Gangnam Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Sung Ku Kang
- Department of Urology, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Hyunho Han
- Department of Urology, Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.
| | - Young Deuk Choi
- Department of Urology, Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea
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Goldstein I, Hassan T, Zou K, Divino V, DeKoven M, Imperato J, Anupindi VR, Li J. Health-Care Resource Utilization and Treatment Patterns in Men with Erectile Dysfunction and Benign Prostatic Hyperplasia-Associated Lower Urinary Tract Symptoms in the United States: A Retrospective Database Study. Patient Prefer Adherence 2023; 17:2187-2200. [PMID: 37701428 PMCID: PMC10493135 DOI: 10.2147/ppa.s412969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 08/04/2023] [Indexed: 09/14/2023] Open
Abstract
Objective To compare health-care resource utilization (HCRU) outcomes in patients with erectile dysfunction (ED) and benign prostatic hyperplasia-associated lower urinary tract symptoms (BPH-LUTS) treated with tadalafil or non-phosphodiesterase-5 inhibitor (PDE5i), adherence to and persistence with tadalafil by dose in the United States (US). Methods This was a noninterventional, real-world evidence study of men (aged ≥45 years) with ED and BPH-LUTS treated with tadalafil or non-PDE5i. The IQVIA US PharMetrics Plus claims database was used. Outcomes included all-cause and disease-specific HCRU over a 12-month follow-up. Persistence with and adherence to tadalafil were evaluated stratified by dose (10 or 20 mg as needed; 2.5 or 5 mg as once daily [OD]). Results The final sample comprised 11,351 tadalafil and 48,722 non-PDE5i patients. For all-cause and disease-specific HCRU, including prescription fills, physician office visits, emergency room visits, laboratory tests, radiology examinations, outpatient surgical services, ancillary services, hospitalizations, mean number of utilizations, and proportions of patients with one or more utilizations, were lower for tadalafil compared with non-PDE5i patients. For all-cause HCRU, proportions of patients with one or more emergency room visits (18.6% vs 21.7%, p<0.0001) and outpatient surgical visits (63.0% vs 68.8%, p<0.0001) were significantly lower for tadalafil compared with non-PDE5i patients. For disease-specific HCRU, the proportion with one or more disease-specific physician office visits (55.1% vs 91.4%), laboratory tests (34.8% vs 58.2%), outpatient surgery (24.3% vs 38.9%), or outpatient ancillary services (18.0% vs 29.8%) were significantly lower for tadalafil compared with non-PDE5i patients (all comparisons, p<0.0001). Mean persistence days (179.8 vs 61.2), proportion persistence (35.8% vs 6.5%), and mean adherence (0.5 vs 0.2) were higher for tadalafil OD doses than as-needed tadalafil doses. Conclusion Patients on tadalafil demonstrated less HCRU and higher persistence and adherence (OD versus as-needed tadalafil) than non-PDE5i patients, which demonstrates its benefit in the management of ED and BPH-LUTS in the US.
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Affiliation(s)
- Irwin Goldstein
- Department of Sexual Medicine, Alvarado Hospital, San Diego, CA, USA
| | - Tarek Hassan
- Department of Urology, Viatris Inc, Canonsburg, PA, USA
| | - Kelly Zou
- Global Medical Analytics and Real World Evidence, Viatris Inc, Canonsburg, PA, USA
| | - Victoria Divino
- Health Economics/Outcomes Research and Real-World Insights, IQVIA, Falls Church, VA, USA
| | - Mitch DeKoven
- Health Economics/Outcomes Research and Real-World Insights, IQVIA, Falls Church, VA, USA
| | - Joseph Imperato
- Global Medical Analytics and Real World Evidence, Viatris Inc, Canonsburg, PA, USA
| | | | - Jim Li
- Global Medical Analytics and Real World Evidence, Viatris Inc, Canonsburg, PA, USA
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Lei Y, Wang T, Roper J, Tian S, Patel P, Bradley JD, Jani AB, Liu T, Yang X. Automatic segmentation of neurovascular bundle on mri using deep learning based topological modulated network. Med Phys 2023; 50:5479-5488. [PMID: 36939189 PMCID: PMC10509305 DOI: 10.1002/mp.16378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 01/20/2023] [Accepted: 03/09/2023] [Indexed: 03/21/2023] Open
Abstract
PURPOSE Radiation damage on neurovascular bundles (NVBs) may be the cause of sexual dysfunction after radiotherapy for prostate cancer. However, it is challenging to delineate NVBs as organ-at-risks from planning CTs during radiotherapy. Recently, the integration of MR into radiotherapy made NVBs contour delineating possible. In this study, we aim to develop an MRI-based deep learning method for automatic NVB segmentation. METHODS The proposed method, named topological modulated network, consists of three subnetworks, that is, a focal modulation, a hierarchical block and a topological fully convolutional network (FCN). The focal modulation is used to derive the location and bounds of left and right NVBs', namely the candidate volume-of-interests (VOIs). The hierarchical block aims to highlight the NVB boundaries information on derived feature map. The topological FCN then segments the NVBs inside the VOIs by considering the topological consistency nature of the vascular delineating. Based on the location information of candidate VOIs, the segmentations of NVBs can then be brought back to the input MRI's coordinate system. RESULTS A five-fold cross-validation study was performed on 60 patient cases to evaluate the performance of the proposed method. The segmented results were compared with manual contours. The Dice similarity coefficient (DSC) and 95th percentile Hausdorff distance (HD95 ) are (left NVB) 0.81 ± 0.10, 1.49 ± 0.88 mm, and (right NVB) 0.80 ± 0.15, 1.54 ± 1.22 mm, respectively. CONCLUSION We proposed a novel deep learning-based segmentation method for NVBs on pelvic MR images. The good segmentation agreement of our method with the manually drawn ground truth contours supports the feasibility of the proposed method, which can be potentially used to spare NVBs during proton and photon radiotherapy and thereby improve the quality of life for prostate cancer patients.
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Affiliation(s)
- Yang Lei
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
| | - Tonghe Wang
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, USA
| | - Justin Roper
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
| | - Sibo Tian
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
| | - Pretesh Patel
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
| | - Jeffrey D Bradley
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
| | - Ashesh B Jani
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
| | - Tian Liu
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Xiaofeng Yang
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
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11
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Feng X, Mei Y, Wang X, Cui L, Xu R. Association between neutrophil to lymphocyte ratio and erectile dysfunction among US males: a population-based cross-sectional study. Front Endocrinol (Lausanne) 2023; 14:1192113. [PMID: 37424870 PMCID: PMC10326541 DOI: 10.3389/fendo.2023.1192113] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 06/05/2023] [Indexed: 07/11/2023] Open
Abstract
Objective The purpose of the study was to investigate the relationship between neutrophil-to-lymphocyte ratio (NLR) and erectile dysfunction (ED) in adult American males using a large database. Methods We adopted a series of statistical analyses of the relationship between NLR indices and ED prevalence among participants in the 2001-2004 National Health and Nutrition Examination Survey (NHANES) database using the R software. Results The study included a total of 3012 participants, of whom 570 (18.9%) presented with ED. NLR levels were 2.13 (95% CI: 2.08,2.17) in those without ED and 2.36 (95% CI: 2.27,2.45) in those with ED. After adjusting for confounding variables, NLR levels were higher in patients with ED, (β, 1.21, 95% CI, 1.09-1.34, P < 0.001). In addition, a U-shaped relationship between NLR and ED was observed after controlling for all confounders. A more significant correlation (β, 1.35, 95% CI, 1.19 to 1.53, P < 0.001) existed to the right of the inflection point (1.52). Conclusion The results of the large cross-sectional study showed a statistically significant association between the occurrence of ED and NLR, a simple, inexpensive, and readily available parameter of inflammation, in US adults. Further studies are still needed in the future to validate and replicate our findings and to investigate the specific mechanisms involved.
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Affiliation(s)
- Xingliang Feng
- Department of Urology, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China
- Department of Urology, First People’s Hospital of Changzhou, Changzhou, Jiangsu, China
| | - Yangyang Mei
- Department of Urology, Jiangyin People’s Hospital of Jiangsu Province, Jiangyin, China
| | - Xiaogang Wang
- Department of Urology, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China
- Department of Urology, First People’s Hospital of Changzhou, Changzhou, Jiangsu, China
| | - Li Cui
- Department of Urology, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China
- Department of Urology, First People’s Hospital of Changzhou, Changzhou, Jiangsu, China
| | - Renfang Xu
- Department of Urology, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China
- Department of Urology, First People’s Hospital of Changzhou, Changzhou, Jiangsu, China
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Sikhymbaev M, Ospanova D, Grzhibovsky A, Akkaliyev M, Kurmanbekov T, Tanabayeva S, Saliev T, Altynbekov S, Fakhradiyev I. Evaluation of the sexual function of men in Kazakhstan during 2021-2022: A cross-sectional study. Health Sci Rep 2023; 6:e1142. [PMID: 36865526 PMCID: PMC9972868 DOI: 10.1002/hsr2.1142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 02/17/2023] [Accepted: 02/18/2023] [Indexed: 03/04/2023] Open
Abstract
Background and Aims Assessing male sexual function is an important public health issue in every country. In Kazakhstan, there are currently no reliable statistics on male sexual function. The study aimed at the assessment of sexual function in men in Kazakhstan. Methods Men between the ages of 18 and 69 from Astana, Almaty, and Shymkent, three of Kazakhstan's biggest cities, were included in the cross-sectional study in 2021-2022. A standardized and modified Brief Sexual Function Inventory (BSFI) tool was used for participants' interviews. The World Health Organization STEPS questionnaire was employed to gather sociodemographic information, including smoking and alcohol use. Results Respondents from three cities: n = 283 from Almaty, n = 254 from Astana, and n = 232 from Shymkent were interviewed. All participants' average age was 39.2 ± 13.4. Kazakhs made up 79.5% of the respondents by nationality; 19.1% who answered questions on physical activity verified that they were involved in high-intensity labor. According to the BSFI questionnaire, the respondents from Shymkent had an average total score of 2.82 ± 0.92, (p ≤ 0.05), which was higher than the total scores of respondents from Almaty (2.69 ± 0.87) and Astana (2.69 ± 0.95). A relationship was found between sexual dysfunction and age indicators over 55 years. Participants with overweight had a relationship with sexual dysfunction with an odds ratio (OR): 1.84 (p = 0.01). According to the smoking factor, in study participants with sexual dysfunction, a relationship was also determined, OR: 1.42; 95% confidence interval (CI): 0.79-1.97 (p = 0.001). The presence of high-intensity activity (OR: 1.58; 95% CI: 0.04-1.91), and physical inactivity (OR: 1.49; 95% CI: 0.89-1.97) were associated with the presence of sexual dysfunction, p ≤ 0.05. Conclusions Our research indicates that men over 50 who smoke, are overweight, and are physically inactive are at risk for sexual dysfunction. Early health promotion may be the most effective method to reduce the negative effects of sexual dysfunction on the health and wellbeing of men over 50.
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Affiliation(s)
- Marat Sikhymbaev
- Department of MedicineS.D. Asfendiyarov Kazakh National Medical UniversityAlmatyRepublic of Kazakhstan
| | - Dinara Ospanova
- Department of MedicineAl‐Farabi Kazakh National l UniversityAlmatyRepublic of Kazakhstan
| | - Andrey Grzhibovsky
- Department of MedicineNorthern State Medical UniversityArkhangelskRussian Federation
| | - Merkhat Akkaliyev
- Department of MedicineSemey Medical UniversityAlmatyRepublic of Kazakhstan
| | - Turar Kurmanbekov
- Department of MedicineS.D. Asfendiyarov Kazakh National Medical UniversityAlmatyRepublic of Kazakhstan
| | - Shynar Tanabayeva
- Department of MedicineS.D. Asfendiyarov Kazakh National Medical UniversityAlmatyRepublic of Kazakhstan
| | - Timur Saliev
- Department of MedicineS.D. Asfendiyarov Kazakh National Medical UniversityAlmatyRepublic of Kazakhstan
| | - Sagat Altynbekov
- Department of MedicineS.D. Asfendiyarov Kazakh National Medical UniversityAlmatyRepublic of Kazakhstan
| | - Ildar Fakhradiyev
- Department of MedicineS.D. Asfendiyarov Kazakh National Medical UniversityAlmatyRepublic of Kazakhstan
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Dilixiati D, Kadier K, Laihaiti D, Lu JD, Azhati B, Rexiati M. The association between sexual dysfunction and prostate cancer: a systematic review and meta-analysis. J Sex Med 2023; 20:184-193. [PMID: 36763951 DOI: 10.1093/jsxmed/qdac025] [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: 08/12/2022] [Revised: 10/13/2022] [Accepted: 10/19/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND Whether there is a connection between sexual dysfunction (SD) and prostate cancer (PCa) is controversial. AIM We sought to review the interrelationship between SD and PCa and to determine whether there is a definitive risk of men developing PCa after suffering from SD. METHODS A complete search of the PubMed, Web of Science, Ovid MEDLINE, Embase, and Cochrane Library databases was performed to search for eligible studies published up to October 2022. The protocol for this meta-analysis is available from PROSPERO (ID: CRD42022342381). OUTCOMES The associations between SD and the risk of PCa were assessed by calculating pooled ORs with 95% CIs, and the standard mean difference (SMD) and its 95% CI were used to assess the relationship between SD and prostate-specific antigen (PSA) levels or prostate volume (PV). Random-effects models were used to account for potential heterogeneity, and the Newcastle-Ottawa Scale (NOS) was used to evaluate the quality of the included studies. RESULTS Twenty studies involving 215,626 individuals were included in our meta-analysis. Compared with controls, subjects with SD had a 1.62-fold increased risk of PCa (OR = 1.62, 95% CI, 1.77-2.23, P = .003; heterogeneity: I2 = 97.8%, P < .001). Patients with SD had higher PSA levels than controls (SMD =0.07, 95% CI, 0.00 to 0.13, P = .041; heterogeneity: I2 = 55.6%, P = .027). However, there was no association between SD and PV (SMD = 0.03, 95% CI, -0.05 to 0.11, P = .122; heterogeneity: I2 = 48.5%, P = .100). CLINICAL IMPLICATIONS Current evidence confirms a potential link between SD and the risk of PCa and that SD in PCa patients should be of concern to clinicians. STRENGTHS AND LIMITATIONS The strength of this study is that it is to our knowledge the first meta-analysis of studies on the risk of PCa in men with SD. A limitation is that most of the studies included in this meta-analysis focused on ED. CONCLUSION Our systematic review and meta-analysis results suggest that men with SD have a higher risk of PCa and higher PSA levels than men without SD. However, this is merely inferential, and causality cannot be determined based on the current data. Further longitudinal studies should be performed to validate our preliminary findings.
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Affiliation(s)
- Diliyaer Dilixiati
- Department of Urology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.,Xinjiang Clinical Medical Research Center of Urogenital Diseases, Urumqi, China
| | - Kaisaierjiang Kadier
- Clinical Medical College, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Duolikun Laihaiti
- Department of Joint Surgery, Changji Branch of First Affiliated Hospital of Xinjiang Medical University, Changji, China
| | - Jian-De Lu
- Clinical Medical College, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Baihetiya Azhati
- Department of Urology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.,Xinjiang Clinical Medical Research Center of Urogenital Diseases, Urumqi, China
| | - Mulati Rexiati
- Department of Urology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.,Xinjiang Clinical Medical Research Center of Urogenital Diseases, Urumqi, China
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14
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An evaluation of race-based representation among men participating in clinical trials for prostate cancer and erectile dysfunction. Contemp Clin Trials Commun 2022; 29:100986. [PMID: 36092973 PMCID: PMC9450121 DOI: 10.1016/j.conctc.2022.100986] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 08/23/2022] [Indexed: 11/23/2022] Open
Abstract
Background Inclusion of ethnic/racial minorities in clinical trials is essential to fully assess therapeutic efficacy. It is well-known that populations respond dissimilarly to interventions. Our objective is to analyze the inclusion of minority men in clinical trials for erectile dysfunction (ED). Methods We searched ClinicalTrials.gov for the disease keyword: "Erectile Dysfunction" and used "Prostate Cancer" for comparison. Completed trials which reported demographic data were included for analysis. Literature was reviewed to determine the prevalence of ED and prostate cancer (PC) among Hispanic, Black, White, and Asian men. The proportion of individuals of each group that participated in trials is divided by the proportion of each group in the disease population to calculate the "Participation to Prevalence Ratio" (PPR). PPRs between 0.8 and 1.2 indicates adequate representation, <0.8 is under-representation and >1.2 is over-representation. Results A total of 312 trials were assessed: 289 for prostate cancer and 23 for ED. Hispanic men comprised 11.8% of ED trial participants and 4.6% of prostate cancer trial participants, yet represented 18% of ED patients and 7.3% of PC patients. Black/African-American (AA) men accounted for 10.2% of ED trial participants and 9.4% of PC trial participants, but comprise 16% of ED patients, and 16.3% of PC patients. Hispanic and AA men are under-represented in trials for ED and Prostate Cancer (Hispanic ED PPR = 0.66; Hispanic PC PPR = 0.63; AA ED PPR = 0.64; AA PC PPR = 0.58). Conclusion Our analysis shows that both Hispanic and AA men are underrepresented in both ED and PC clinical trials.
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Key Words
- AA, Black/African American
- Andrology
- CBPR, Community Based Participatory Research
- Clinical Trials
- Diversity
- ED, Erectile Dysfunction
- FDA, United States Food and Drug Administration
- Generalizability
- Health equity
- ICD 10, International Classification of Disease, Tenth Revision
- NCI, National Cancer Institute
- NIH, United States National Institutes of Health
- PC, Prostate Cancer
- PPR, Participation to Prevalence Ratio
- RQ, Representation Quotients
- URM, Under-represented Minority
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15
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Vance G, Zeigler-Hill V, Shackelford TK. Erectile Dysfunction and Sexual Coercion: The Role of Sperm Competition Risk. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:2781-2790. [PMID: 35778580 DOI: 10.1007/s10508-022-02300-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 01/23/2022] [Accepted: 01/26/2022] [Indexed: 06/15/2023]
Abstract
Erectile dysfunction (ED) has been shown to be associated with several negative aspects of intimate relationships. Our goal for the present research was to examine whether ED was associated with men's use of sexual coercion in their intimate relationships (which may include the use of physical coercion, psychological manipulation, or emotional manipulation to gain sexual access) and if perceived sperm competition risk (i.e., perceived risk of partner infidelity, which may place a man's sperm into competition with sperm from another man) played a role in this association. These associations were examined in Study 1 using self-reports provided by men (N = 202) who had a mean age of 30.48 years (SD = 5.03) and were recruited through Amazon's Mechanical Turk (MTurk). ED was found to have a large positive association with sexual coercion. However, men's self-reports did not provide support for sperm competition risk moderating the association between ED and sexual coercion, but an exploratory analysis revealed that sperm competition risk mediated this association. We attempted to replicate and extend these results in Study 2 by using partner-reports provided by women (N = 151) who had a mean age of 30.41 years (SD = 4.77) and were recruited through MTurk. Women's partner-reports provided support for sperm competition risk moderating the association between ED and sexual coercion. In addition, an exploratory analysis found that sperm competition risk also mediated the association between ED and sexual coercion, similar to Study 1. Discussion explores the implications of these results for understanding the role that sperm competition risk may play in the connection between ED and sexual coercion.
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Affiliation(s)
- Gavin Vance
- Department of Psychology, Center for Evolutionary Psychological Science, Oakland University, Rochester, MI, 48309, USA.
| | - Virgil Zeigler-Hill
- Department of Psychology, Center for Evolutionary Psychological Science, Oakland University, Rochester, MI, 48309, USA
| | - Todd K Shackelford
- Department of Psychology, Center for Evolutionary Psychological Science, Oakland University, Rochester, MI, 48309, USA
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Illiano E, Trama F, Ruffo A, Romeo G, Riccardo F, Iacono F, Costantini E. Shear wave elastography as a new, non-invasive diagnostic modality for the diagnosis of penile elasticity: a prospective multicenter study. Ther Adv Urol 2021; 13:17562872211007978. [PMID: 33953801 PMCID: PMC8058793 DOI: 10.1177/17562872211007978] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 03/15/2021] [Indexed: 12/13/2022] Open
Abstract
Objective: Shear wave elastosonography (SWE) could be used to evaluate the elasticity of penile tissue. Few studies in the literature, however, have investigated its use in patients with erectile dysfunction (ED) or have attempted to correlate findings with International Index of Erectile Function (IIEF-5) scores. The primary aim of this study was to evaluate the characteristics of erectile tissue using SWE and to determine possible relationships with IIEF-5 and Erection Hardness Scale (EHS) scores. The secondary aim was to establish a cut-off SWE examination value over which cavernous tissue stiffness could contribute to a subsequent organic alteration. Methods: This prospective study included male patients 18−80 years of age who attended two general andrology clinics and underwent SWE. Subjects were divided into groups according to IIEF-5 score, and correlations between SWE and IIEF-5 and EHS questionnaire scores were explored. Results: A total of 270 subjects (mean age 46.7 ± 16.9 years) were included. ED was reflected by low IIEF-5 and EHS scores and a decrease in the mean elasticity of the corpora cavernosa according to SWE, although the difference between the left and right corpora cavernosa was not statistically significant. No statistically significant correlation was found between measurements of the corpora cavernosa (in kPa) and age. The optimal cut-off identified was 24.75 kPa. Conclusion: Results demonstrated that the mean elasticity of the corpora cavernosa according to SWE was correlated with IIEF-5 score and EHS score.
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Affiliation(s)
- Ester Illiano
- Andrology and Urogynecology Clinic, Santa Maria Terni Hospital, University of Perugia, Perugia, Italy
| | - Francesco Trama
- Andrology and Urogynecology Clinic, Santa Maria Terni Hospital, University of Perugia, Viale Tristano di Jannuccio 1 Terni, Perugia, 06123, Italy
| | - Antonio Ruffo
- Andrea Grimaldi Hospital, San Giorgio a Cremano (NA), Italy
| | - Giuseppe Romeo
- Urology Department, A.O.R.N. A. Cardarelli, Naples, Italy
| | - Filippo Riccardo
- Department of General and Specialized Surgeries, Renal Transplantation, Nephrology, Intensive Care and Pain Management, University of Federico II, Naples, Italy
| | - Fabrizio Iacono
- Department of General and Specialized Surgeries, Renal Transplantation, Nephrology, Intensive Care and Pain Management, University of Federico II, Naples, Italy
| | - Elisabetta Costantini
- Andrology and Urogynecology Clinic, Santa Maria Terni Hospital, University of Perugia, Perugia, Italy
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Lee JH, Min AY, Park OR, Han JH, Yang YJ, Kim H, Baek SY. Detection of 94 compounds related to sexual enhancement including sildenafil, tadalafil, vardenafil and their analogues in various formulations of dietary supplements and food samples using HPLC and LC-MS/MS. Food Addit Contam Part A Chem Anal Control Expo Risk Assess 2021; 38:769-781. [PMID: 33818311 DOI: 10.1080/19440049.2021.1881623] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
With an increase in the detection of structural and functional analogues of phosphodiesterase type 5 inhibitors (PDE-5i) in dietary supplements (DS) and foods, public health is threatened. Some products advertise natural ingredients despite containing PDE-5i that can cause serious adverse effects on human health. To avoid detection during routine screening, novel PDE-5i have been synthesised and added to DS and foods. The purpose of this study was to detect, identify, and quantify 94 PDE-5i and related compounds in DS and foods. Furthermore, the study investigated the detection cases and compared them by sample type, formulation, and compounds. The HPLC and LC-MS/MS methods were validated for limit of detection (LOD), limit of quantification (LOQ), linearity, and recovery in solid and liquid type samples. Both HPLC and LC-MS/MS showed satisfactory results, which were in conformance with the ICH guidelines. A total of 404 samples, including DS (99), and foods (305) were purchased from online and offline markets. Samples divided into 5 types of formulation were analysed; tablet, capsule, pilula (herbal medicine pill), powder and liquid type. Of these 130 samples (47 of 99 DS, and 83 of 305 foods) contained one or more PDE-5i or related compounds. Among the five types of formulation, the tablet type showed the highest detection rate (61.1%) in DS, whereas the capsule type showed the highest detection rate (53.8%) in food samples. This study will be helpful for monitoring illegal ED-related products, providing information to consumers, and ultimately contributing to protecting public health.
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Affiliation(s)
- Ji Hyun Lee
- Center for Advanced Analysis, National Institute of Food and Drug Safety Evaluation, Ministry of Food and Drug Safety, Cheongju-si, Republic of Korea
| | - A Young Min
- Center for Advanced Analysis, National Institute of Food and Drug Safety Evaluation, Ministry of Food and Drug Safety, Cheongju-si, Republic of Korea
| | - Ok Rim Park
- Center for Advanced Analysis, National Institute of Food and Drug Safety Evaluation, Ministry of Food and Drug Safety, Cheongju-si, Republic of Korea
| | - Ji Hye Han
- Center for Advanced Analysis, National Institute of Food and Drug Safety Evaluation, Ministry of Food and Drug Safety, Cheongju-si, Republic of Korea
| | - Yoon Ji Yang
- Center for Advanced Analysis, National Institute of Food and Drug Safety Evaluation, Ministry of Food and Drug Safety, Cheongju-si, Republic of Korea
| | - Hyungil Kim
- Center for Advanced Analysis, National Institute of Food and Drug Safety Evaluation, Ministry of Food and Drug Safety, Cheongju-si, Republic of Korea
| | - Sun Young Baek
- Center for Advanced Analysis, National Institute of Food and Drug Safety Evaluation, Ministry of Food and Drug Safety, Cheongju-si, Republic of Korea
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18
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Elnaser Mohamed TA, Kamel II, Abdelaal AMA, Mohammad AF, GamalEl Din SF. Study of the risk factors of erectile dysfunction and phospho diestrase type 5 inhibitors usage among Egyptian population with erectile dysfunction: A cross-sectional survey. Rev Int Androl 2021; 19:249-258. [PMID: 33773939 DOI: 10.1016/j.androl.2020.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 04/05/2020] [Accepted: 05/02/2020] [Indexed: 10/21/2022]
Abstract
OBJECTIVES We aimed to study the risk factors of erectile dysfunction (ED) and different patterns of phosphodiestrase type 5 inhibitors (PDE5is) usage among Egyptian patients. PATIENTS AND METHODS One thousand five hundred consecutive Egyptian patients complaining of ED were included in this cross-sectional study from July (2014) to October (2015). Patients were requested to answer the international index of erectile function questionnaire (IIEF-5). Statistical differences between groups were tested using Chi square test and Spearman's rho correlation coefficient for qualitative variables. RESULTS Remarkably, significant associations between IIEF scores and aging and diabetes mellitus (DM) and hypertension (HTN) and ischaemic heart disease (IHD) and hyperlipidaemia were shown in the studied patients (p<.0001, p<.0001, p<.0001, p<.0001, p<.0001, respectively). Eventually, our study showed significant correlations between different age groups and morning erection and lower urinary tract symptoms and HTN and IHD and DM where the severity of ED was directly proportional to the absence or decreased strength of morning erection with aging and the increased incidence of LUTS and HTN and IHD and DM with aging (p<.0001; p=.001; p<.0001; p<.0001; p<.0001, respectively). CONCLUSION Our study demonstrated that aging; DM, HTN and hyperlipidaemia are potential major risk factors of ED in Egypt for further validation. In addition, most of the participants used PDE5is without prior medical consultation together with concomitant administration of illicit drugs.
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Affiliation(s)
| | - Ihab Ismail Kamel
- Andrology & STDs Department, Kasr Al-Ainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | | | | | - Sameh Fayek GamalEl Din
- Andrology & STDs Department, Kasr Al-Ainy Faculty of Medicine, Cairo University, Cairo, Egypt.
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Heinsimer K, Wiegand L. Erectile and Ejaculatory Dysfunction After Urethroplasty. Curr Urol Rep 2021; 22:19. [PMID: 33554283 DOI: 10.1007/s11934-021-01039-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE OF THE REVIEW The goal of this paper was to evaluate the impact on erectile and ejaculatory function after anterior and posterior urethroplasty. RECENT FINDINGS With a rise in the use of urethroplasty, its impact on sexual function has come into question. For anterior urethroplasties, some degree of erectile dysfunction is common, but this tends to be transient, with most patients having a resolution of any de novo dysfunction by 12 months. Patients with posterior urethral strictures have a very high rate of erectile dysfunction prior to surgery and may show improvement after urethroplasty. Ejaculatory function tends to improve in patients due to alleviation of obstruction while some patients notice degradation in force of ejaculation. While urethroplasty has a minimal permanent effect on sexual function for most patients, there are some patients who notice improvement and others worsening. Patients should be counseled on these risks prior to urethroplasty.
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Affiliation(s)
- Kevin Heinsimer
- Department of Urology, University of South Florida, Tampa General Circle, STC Floor 6, Tampa, FL, 33606, USA.
| | - Lucas Wiegand
- Department of Urology, University of South Florida, Tampa General Circle, STC Floor 6, Tampa, FL, 33606, USA
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20
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Sun K, Sun F, Yao H, Zhang D, Wu G, Wang T, Wang J, Wu J. Efficacy and Safety of Combination Comprising Tamsulosin and PDE5-Is, Relative to Monotherapies, in Treating Lower Urinary Tract Symptoms and Erectile Dysfunction Associated With Benign Prostatic Hyperplasia: A Meta-Analysis. Am J Mens Health 2020; 14:1557988320980180. [PMID: 33342335 PMCID: PMC7756049 DOI: 10.1177/1557988320980180] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
We report safety and efficacy of a combination therapy, comprising tamsulosin and phosphodiesterase type 5 inhibitors (PDE5-Is), relative to monotherapy, to ascertain its potential in treating lower urinary tract symptoms (LUTS) and erectile dysfunction (ED) secondary to benign prostatic hyperplasia (BPH) after 3 months’ treatment. We screened MEDLINE, EMBASE, and the Cochrane Controlled Trials Register databases, for randomized controlled trials, and obtained eight articles comprising 1144 participants. Results showed that the combination group had superior outcomes with regard to International Prostate Symptom Score (IPSS) and Qmax, compared to the other two groups. The combination group also had superior efficacy with regard to International Index of Erectile Function (IIEF) than the tamsulosin group, but not over the PDE5-Is group. Further, the combination group showed better efficacy in IPSS voiding and quality of life (QoL) compared to the PDE5-Is group. An analysis of safety outcomes revealed extremely high adverse events (AEs) and pain in the combination group. However, therapy discontinuation due to pain and AEs did not increase with increase in AEs. Overall, our findings indicate that a combination of tamsulosin and PDE5-Is is superior to individual tamsulosin and PDE5-Is monotherapy, with regard to improving LUTS and ED secondary to BPH.
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Affiliation(s)
- Kai Sun
- Department of Urology, Affiliated Yantai Yuhuangding Hospital, Qingdao University, Yantai, Shandong, China
| | - Fengze Sun
- Department of Urology, Affiliated Yantai Yuhuangding Hospital, Qingdao University, Yantai, Shandong, China
| | - Huibao Yao
- Department of Urology, Affiliated Yantai Yuhuangding Hospital, Qingdao University, Yantai, Shandong, China
| | - Dongxu Zhang
- Department of Urology, Affiliated Yantai Yuhuangding Hospital, Qingdao University, Yantai, Shandong, China
| | - Gang Wu
- Department of Urology, Affiliated Yantai Yuhuangding Hospital, Qingdao University, Yantai, Shandong, China
| | - Tianqi Wang
- Department of Urology, Affiliated Yantai Yuhuangding Hospital, Qingdao University, Yantai, Shandong, China
| | - Jipeng Wang
- Department of Urology, Affiliated Yantai Yuhuangding Hospital, Qingdao University, Yantai, Shandong, China
| | - JiTao Wu
- Department of Urology, Affiliated Yantai Yuhuangding Hospital, Qingdao University, Yantai, Shandong, China
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Abstract
With the onset of a metabolic syndrome epidemic and the increasing life expectancy, erectile dysfunction (ED) has become a more common condition. As incidence and prevalence increase, the medical field is focused on providing more appropriate therapies. It is common knowledge that ED is a chronic condition that is also associated with a myriad of other disorders. Conditions such as aging, diabetes mellitus, hypertension, obesity, prostatic hypertrophy, and prostate cancer, among others, have a direct implication on the onset and progression of ED. Characterization and recognition of risk factors may help clinicians recognize and properly treat patients suffering from ED. One of the most reliable treatments for ED is penile prosthetic surgery. Since the introduction of the penile prosthesis (PP) in the early seventies, this surgical procedure has improved the lives of thousands of men, with reliable and satisfactory results. The aim of this review article is to characterize the epidemiology of men undergoing penile prosthetic surgery, with a discussion about the most common conditions involved in the development of ED, and that ultimately drive patients into electing to undergo PP placement.
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Affiliation(s)
- Jose A Saavedra-Belaunde
- Department of Surgery/Division of Urology, University of Texas Medical Science Center at Houston, Houston, TX 77030, USA
| | | | - Run Wang
- Department of Surgery/Division of Urology, University of Texas Medical Science Center at Houston, Houston, TX 77030, USA
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Alwaal A, Awad M, Boggs N, Kuzbel J, Snoad B. Sexual Health Inventory for Men Questionnaire as a Screening Method for Erectile Dysfunction in a General Urology Clinic. Sex Med 2020; 8:660-663. [PMID: 32919921 PMCID: PMC7691874 DOI: 10.1016/j.esxm.2020.08.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 07/21/2020] [Accepted: 08/05/2020] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Sexual Health Inventory for Men (SHIM) is a validated questionnaire that is widely used in urology clinics to evaluate and assess treatment efficacy for erectile dysfunction (ED). AIM In this study, we evaluated the benefit of using the SHIM questionnaire as a screening tool for ED in a general urology clinic MATERIAL AND METHODS: We retrospectively reviewed records of patients presenting to our general urology clinic from October 2018 to June 2019. During this period, all new male urology patients who are 40 years of age or older visiting the general urology clinic for any urologic condition received the SHIM questionnaire. We excluded all patients whose chief complaint was ED, Peyronie's disease, and hypogonadism. Patients were then asked if they want treatment for ED, and those patients who did, received a full ED evaluation and treatment. Factors associated with desire for ED treatment were analyzed using logistic regression. MAIN OUTCOME MEASURES SHIM score, desire for ED treatment, and factors influencing desire for treatment. RESULTS Three hundred seventy-nine patients received the SHIM questionnaire. Of which, 48 patients (12.7%) declined to fill the questionnaire. We excluded all patients presenting for sexual health issues (67 patients, 17.7%). We included the remaining 264 patients (69.6%). The mean age was 61.7 years (range 40 to 85). Older patients were more likely to want ED treatment and had lower SHIM scores. However, older than the age of 70 years, there was a decline in the number of patients wanting treatment. In a multivariate regression analysis, age between 61 and 70 years and having diabetes mellitus were associated with the desire for ED treatment. CONCLUSIONS The SHIM questionnaire is a useful tool in the general urology clinic. It can serve as an efficient tool to screen for and quantify ED in patients presenting for other urologic issues. Maximum benefit is seen in patients between the age of 51 and 70 years and in patients with diabetes. Alwaal A, Awad M, Boggs N, et al. Sexual Health Inventory for Men Questionnaire as a Screening Method for Erectile Dysfunction in a General Urology Clinic. Sex Med 2020;8:660-663.
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Affiliation(s)
- Amjad Alwaal
- Department of Urology, Marshall University, Huntington, WV, USA.
| | - Mohannad Awad
- Department of Surgery, Division of Urology, University of Vermont Medical Center, Burlington, VT, USA; Department of Surgery, King Abdulaziz University, Rabigh, Saudi Arabia
| | - Nathan Boggs
- Department of Urology, Marshall University, Huntington, WV, USA
| | - Jake Kuzbel
- Department of Urology, Marshall University, Huntington, WV, USA
| | - Brian Snoad
- Department of Urology, Marshall University, Huntington, WV, USA
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Geerkens MJ, Al-Itejawi HH, Nieuwenhuijzen JA, Meuleman EJ, Lissenberg-Witte BI, van Moorselaar R, Vis AN. Sexual Dysfunction and Bother Due to Erectile Dysfunction in the Healthy Elderly Male Population: Prevalence from a Systematic Review. Eur Urol Focus 2020; 6:776-790. [DOI: 10.1016/j.euf.2019.03.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 02/12/2019] [Accepted: 03/04/2019] [Indexed: 11/29/2022]
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Utility of dynamic MRA in the evaluation of male erectile dysfunction. Abdom Radiol (NY) 2020; 45:1990-2000. [PMID: 31784778 DOI: 10.1007/s00261-019-02339-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE To assess the efficacy of time-resolved MR angiography (MRA) in evaluating penile vasculature in patients with clinically suspected vascular anomalies contributing to their erectile dysfunction correlating with penile doppler ultrasound (PDUS) findings and clinical outcomes after surgical intervention. METHODS Men (n = 26) with signs of early vascular shunting on PDUS underwent time-resolved, contrast-enhanced (0.1 mMol/kg gadobutrol at 1 ml/s followed by saline flush) 3-dimensional spoiled gradient echo T1-weighted MRA sequence performed over 3 min with 4.6 s frame rate after intracavernosal injection of an erectogenic agent. Additional T1- and T2-weighted sequences were performed for anatomic co-localization and tissue characterization. MRA images were evaluated for early filling of draining veins as well as arteriovenous malformations and fistulas and correlated with findings at surgery. RESULTS 29 MRA examinations on 26 patients (mean age 39 years) demonstrated abnormal early venous drainage (n = 22) as well as diminutive/delayed cavernosal enhancement (n = 3), incomplete tumescence (n = 2), and combined arterial inflow/venous outflow disease (n = 1). The MRA had a concordance of 85.2% at determining the presence, or lack thereof of a shunt/AVM when compared to PDUS. CONCLUSIONS Time-resolved MRA allows for both temporal and spatial resolution with visualization of both arterial and venous abnormalities which may be suggested with a screening PDUS examination. This technique allows us to provide detailed anatomic information prior to any surgical intervention.
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Saad F, Caliber M, Doros G, Haider KS, Haider A. Long-term treatment with testosterone undecanoate injections in men with hypogonadism alleviates erectile dysfunction and reduces risk of major adverse cardiovascular events, prostate cancer, and mortality. Aging Male 2020; 23:81-92. [PMID: 30782054 DOI: 10.1080/13685538.2019.1575354] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Objective: The association between erectile dysfunction (ED), hypogonadism, cardiovascular disease, and type 2 diabetes is well documented, but long-term data are limited. The aim of this study is to investigate effects of long-term testosterone therapy (TTh) with testosterone undecanoate in men with hypogonadism and ED.Patients and methods: Observational, prospective registry of 805 hypogonadal men with different degrees of ED, evaluated by the International Index of Erectile Function - Erectile Function Domain. Four hundred and twelve patients underwent TTh, 393 patients served as controls, with an observation period up to 12 years.Results: TTh led to substantial and sustained reduction of ED; improvement in erectile function was significant for each successive year until year 9. This was accompanied by improvements in cardiometabolic risk factors and urinary function throughout the 12-year follow-up period. Benefits of TTh were stronger for patients with moderate/severe ED than for patients with no/minor ED. Incidence of prostate cancer, major adverse cardiovascular events, and mortality were significantly lower in men on TTh compared with untreated men.Conclusion: Long-term TTh for up to 12 years alleviates ED, improves cardiometabolic risk factors, and reduces prostate cancer. Patients must stay on TTh consistently for a long time to achieve maximum benefits of TTh.
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Affiliation(s)
- Farid Saad
- Medical Affairs Andrology, Bayer AG, Berlin, Germany
| | - Monica Caliber
- American Medical Writers Association, Ft Lauderdale, FL, USA
| | - Gheorghe Doros
- Department of Epidemiology and Statistics, Boston University School of Public Health, Boston, TX, USA
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26
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Foy CG, Newman JC, Russell GB, Berlowitz DR, Bates JT, Burgner AM, Carson TY, Chertow GM, Doumas MN, Hughes RY, Kostis JB, Buren PV, Wadley VG. Effect of Intensive vs Standard Blood Pressure Treatment Upon Erectile Function in Hypertensive Men: Findings From the Systolic Blood Pressure Intervention Trial. J Sex Med 2019; 17:238-248. [PMID: 31862174 DOI: 10.1016/j.jsxm.2019.11.256] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 11/04/2019] [Accepted: 11/05/2019] [Indexed: 12/26/2022]
Abstract
INTRODUCTION The effect of intensive blood pressure control upon erectile function in men with hypertension, but without diabetes, is largely unknown. AIM To examine the effects of intensive systolic blood pressure (SBP) lowering on erectile function in a multiethnic clinical trial of men with hypertension. METHODS We performed subgroup analyses from the Systolic Blood Pressure Intervention Trial ([SPRINT]; ClinicalTrials.gov: NCT120602, in a sample of 1255 men aged 50 years or older with hypertension and increased cardiovascular disease risk. Participants were randomly assigned to an intensive treatment group (SBP goal of <120 mmHg) or a standard treatment group (SBP goal of <140 mmHg). MAIN OUTCOME MEASURE The main outcome measure was change in erectile function from baseline, using the 5-item International Index of Erectile Function (IIEF-5) total score, and erectile dysfunction ([ED]; defined as IIEF-5 score ≤21) after a median follow-up of 3 years. RESULTS At baseline, roughly two-thirds (66.1%) of the sample had self-reported ED. At 48 months after randomization, we determined that the effects of more intensive blood pressure lowering were significantly moderated by race-ethnicity (p for interaction = 0.0016), prompting separate analyses stratified by race-ethnicity. In non-Hispanic whites, participants in the intensive treatment group reported slightly, but significantly better change in the IIEF-5 score than those in the standard treatment group (mean difference = 0.67; 95% CI = 0.03, 1.32; P = 0.041). In non-Hispanic blacks, participants in the intensive group reported slightly worse change in the IIEF-5 score than those in the standard group (mean difference = -1.17; 95% CI = -1.92, -0.41; P = 0.0025). However, in non-Hispanic whites and non-Hispanic blacks, further adjustment for the baseline IIEF-5 score resulted in nonsignificant differences (P > 0.05) according to the treatment group. In Hispanic/other participants, there were no significant differences in change in the IIEF-5 score between the two treatment groups (P = 0.40). In a subgroup of 280 participants who did not report ED at baseline, the incidence of ED did not differ in the two treatment groups (P = 0.53) and was without interaction by race-ethnicity. CLINICAL IMPLICATIONS The effect of intensive treatment of blood pressure on erectile function was very small overall and likely not of great clinical magnitude. STRENGTH & LIMITATIONS Although this study included a validated measure of erectile function, testosterone, other androgen, and estrogen levels were not assessed. CONCLUSION In a sample of male patients at high risk for cardiovascular events but without diabetes, targeting a SBP of less than 120 mm Hg, as compared with less than 140 mm Hg, resulted in statistically significant effects on erectile function that differed in accordance with race-ethnicity, although the clinical importance of the differences may be of small magnitude. Foy CG, Newman JC, Russell GB, et al. Effect of Intensive vs Standard Blood Pressure Treatment Upon Erectile Function in Hypertensive Men: Findings From the Systolic Blood Pressure Intervention Trial. J Sex Med 2020;17:238-248.
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Affiliation(s)
- Capri G Foy
- Division of Public Health Sciences, Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA.
| | - Jill C Newman
- Division of Public Health Sciences, Department of Biostatistic and Data Science, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Greg B Russell
- Division of Public Health Sciences, Department of Biostatistic and Data Science, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Dan R Berlowitz
- Bedford VA Hospital, Bedford, MA, and Boston University School of Medicine and Boston University School of Public Health, Boston, MA, USA
| | - Jeffrey T Bates
- Michael E. DeBakey Veterans' Administration Medical Center, Houston, TX, USA
| | - Anna M Burgner
- Division of Nephrology and Hypertension, Department of Medicine, Vanderbilt University, Nashville, TN, USA
| | - Thaddeus Y Carson
- Division of Internal Medicine, Department of Medicine, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Glenn M Chertow
- Division of Nephrology, Department of Medicine, Stanford University, Stanford, CA, USA
| | - Michael N Doumas
- Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece
| | - Robin Y Hughes
- University Hospitals Case Medical Center, Cleveland, OH, USA
| | - John B Kostis
- Robert Wood Johnson Medical School, Rutgers University, University of Medicine and Dentistry of New Jersey, New Brunswick, NJ, USA
| | - Peter van Buren
- Department of Internal Medicine, Dallas Veterans' Administration Medical Center and University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Virginia G Wadley
- Division of Gerontology, Geriatrics and Palliative Care, Department of Medicine, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA
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Bizzarro S, Loos BG. The link between periodontitis and erectile dysfunction: a review. Br Dent J 2019; 227:599-603. [DOI: 10.1038/s41415-019-0724-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Kessler A, Sollie S, Challacombe B, Briggs K, Van Hemelrijck M. The global prevalence of erectile dysfunction: a review. BJU Int 2019; 124:587-599. [PMID: 31267639 DOI: 10.1111/bju.14813] [Citation(s) in RCA: 140] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVE To evaluate the global prevalence of erectile dysfunction (ED); as well as its association with physiological and pathological ageing by examining the relationship between ED and cardiovascular disease (CVD), benign prostatic hyperplasia (BPH), and dementia. We also aimed to characterise discrepancies caused by the use of different ED screening tools. METHODS The Excerpta Medica dataBASE (EMBASE) and Medical Literature Analysis and Retrieval System Online (MEDLINE) were searched to find population-based studies investigating the prevalence of ED and the association between ED and CVD, BPH, and dementia in the general population. RESULTS The global prevalence of ED was 3-76.5%. ED was associated with increasing age. Use of the International Index of Erectile Function (IIEF) and Massachusetts Male Aging Study (MMAS)-derived questionnaire identified a high prevalence of ED in young men. ED was positively associated with CVD. Men with ED have an increased risk of all-cause mortality odds ratio (OR) 1.26 (95% confidence interval [CI] 1.01-1.57), as well as CVD mortality OR 1.43 (95% CI 1.00-2.05). Men with ED are 1.33-6.24-times more likely to have BPH then men without ED, and 1.68-times more likely to develop dementia than men without ED. CONCLUSION ED screening tools in population-based studies are a major source of discrepancy. Non-validated questionnaires may be less sensitive than the IIEF and MMAS-derived questionnaire. ED constitutes a large burden on society given its high prevalence and impact on quality of life, and is also a risk factor for CVD, dementia, and all-cause mortality.
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Affiliation(s)
- Anna Kessler
- School of Cancer and Pharmaceutical Sciences, King's College London, Translational Oncology and Urology Research (TOUR), London, UK
| | - Sam Sollie
- School of Cancer and Pharmaceutical Sciences, King's College London, Translational Oncology and Urology Research (TOUR), London, UK
| | - Ben Challacombe
- Urology Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Karen Briggs
- Urology Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Mieke Van Hemelrijck
- School of Cancer and Pharmaceutical Sciences, King's College London, Translational Oncology and Urology Research (TOUR), London, UK
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Neurocognitive impairment is associated with erectile dysfunction in cirrhotic patients. Dig Liver Dis 2019; 51:850-855. [PMID: 31031175 DOI: 10.1016/j.dld.2019.03.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 03/27/2019] [Accepted: 03/27/2019] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Erectile dysfunction (ED) is common in patients with chronic diseases. It is evaluated using the International Index of Erectile Function (IIEF5) questionnaire. The relationship between ED and cirrhosis is complex. The aims of our study were (1) to assess the prevalence of ED in cirrhosis and (2) to evaluate factors associated with ED, with a special focus on minimal hepatic encephalopathy (MHE). METHODS We performed a prospective, observational study. Patients with cirrhosis were invited to complete the IIEF5 questionnaire. The exclusion criteria were clinical hepatic encephalopathy (HE) and dementia. MHE was evaluated by the psychometric hepatic encephalopathy test score (PHES) and the critical flicker frequency (CFF). RESULTS Between April 2016 and April 2017, 87 patients were included (age: 55 [51-57] years, Child-Pugh score: 8 [7-9], MELD score: 13 [11-16]. Minimal HE was diagnosed in 33% of the patients according to the PHES and in 44% of the patients according to the CFF. ED was diagnosed in 74/87 patients (85%) when compared to 12.5% in healthy controls (p < 0.001). In a multivariate analysis, the independent factors associated with ED were age, Child-Pugh and MELD scores. Significant correlations were identified between the IIEF5 and each component of the PHES. CONCLUSION ED should be systematically screened in cirrhotics, especially in patients with MHE.
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Ruiz-García A, Arranz-Martínez E, Cabrera-Vélez R, Palacios-Martínez D, Rivera-Teijido M, García-Álvarez JC, Morales-Cobos LE, Moreno-Fernández JC, García-Fernández ME, Peña-Antón N, Díez-Pérez MC, Montero-Costa A, Lorenzo-Borda MS, García-Granado MD, Casaseca-Calvo TF, Cique-Herráinz JA, García-Villasur MP, Marañón-Henrich N, Zarzuelo-Martín N, Baltuille-Aller MC, Arribas-Álvaro P, Macho-Barrio AI, Ribot-Catalá C, Capitán-Caldas M, Ciria-de-Pablo C, Sanz-Velasco C, Vargas-Machuca-Cabañero C, Simonaggio-Stancampiano P, Cabello-Igual MP, Sarria-Sánchez MT. Prevalence of erectile dysfunction in Spanish primary care setting and its association with cardiovascular risk factors and cardiovascular diseases. SIMETAP-ED study. CLINICA E INVESTIGACION EN ARTERIOSCLEROSIS 2019; 31:101-110. [PMID: 30979438 DOI: 10.1016/j.arteri.2019.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 10/09/2018] [Accepted: 01/02/2019] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Few studies conducted in primary care setting report about age-adjusted prevalence rates of erectile dysfunction (ED). Aims of SIMETAP-ED study were to determine crude and age-adjusted prevalence rates of ED diagnosis, to compare these rates with other similar studies, and to compare prevalence rates of cardiovascular risk factors (CVRF), cardiovascular diseases (CVD), metabolic diseases and chronic kidney disease (CKD) between populations with and without ED. METHODS Cross-sectional observational study conducted in primary care setting. Population-based random sample: 2934 adult men. Response rate: 66%. A clinical interview was conducted to diagnose ED using a question derived from ED definition. The medical records of patients were reviewed to identify their CVRF and diseases associated with ED. The age-adjustments were standardized to Spanish population. RESULTS The prevalence rates of metabolic diseases, CVD, CVRF, and CKD in population with ED were higher than population without ED, highlighting the CVD. The crude prevalence of ED was 17.2% (95% confidence interval: 15.8-18.6). The age-adjusted prevalence rates of ED were 0.71% in men under 40 years, 12.4% in men over 18 years, 10.8% in men aged 40-69 years, 18.9% in men over 40 years, and 48.6% in men over 70 years. CONCLUSIONS SIMETAP-ED study showed association of ED with metabolic diseases, CKD, CVRF, and highlighting CVD. The age-adjusted prevalence of ED was 12.4% in adult men, 19% in men over 40 years, and almost 50% in men over 70 years.
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Affiliation(s)
- Antonio Ruiz-García
- University Health Center Pinto, Lipids and Cardiovascular Prevention Unit, Madrid Health Service, C/ Marqués, s/n, 28320 Pinto-Madrid, Spain.
| | | | - Roberto Cabrera-Vélez
- University Health Center Espronceda, Madrid Health Service, C/ Espronceda 24, 28003 Madrid, Spain
| | - David Palacios-Martínez
- University Health Center Isabel II, Madrid Health Service, C/ Isabel II, 15, 28982 Parla-Madrid, Spain
| | - Montserrat Rivera-Teijido
- University Health Center Isabel II, Madrid Health Service, C/ Isabel II, 15, 28982 Parla-Madrid, Spain
| | - Juan Carlos García-Álvarez
- University Health Center Dr. Mendiguchia Carriche, Madrid Health Service, Pza. Comunidad de Madrid s/n, 28914 Leganés-Madrid, Spain
| | - Luis Enrique Morales-Cobos
- University Health Center Las Americas, Madrid Health Service, Av. de América, 6, 28981 Parla-Madrid, Spain
| | | | | | - Nuria Peña-Antón
- Health Center El Restón, Madrid Health Service, Av. del Mar Mediterráneo, 1, 28341 Valdemoro-Madrid, Spain
| | - Maria Cruz Díez-Pérez
- Health Center Los Cármenes, Madrid Health Service, C/ Vía Carpetana, 202, 28047 Madrid, Spain
| | | | | | | | | | - Juan A Cique-Herráinz
- Health Center Torito, Madrid Health Service, Camino de vinateros 140, 28030 Madrid, Spain
| | | | - Nuria Marañón-Henrich
- Health Center Las Olivas, Madrid Health Service, P° Deleite, 30, 28300 Aranjuez-Madrid, Spain
| | - Nieves Zarzuelo-Martín
- Health Center Las Olivas, Madrid Health Service, P° Deleite, 30, 28300 Aranjuez-Madrid, Spain
| | | | - Pilar Arribas-Álvaro
- Health Center Campamento, Madrid Health Service, C/ Mirueña s/n, 28024 Madrid, Spain
| | - Ana Isabel Macho-Barrio
- Health Center Vicente Soldevilla, Madrid Health Service, C/ Sierra de Alquife 8, 28053 Madrid, Spain
| | - Carlos Ribot-Catalá
- Health Center Jaime Vera, Madrid Health Service, Av. Europa 1, 28915 Leganés-Madrid, Spain
| | - Mercedes Capitán-Caldas
- Health Center Las Ciudades, Madrid Health Service, C/ Palestina s/n, 28903 Getafe-Madrid, Spain
| | - Cristina Ciria-de-Pablo
- Health Center Hoyo de Manzanares, Madrid Health Service, Pza. Cervantes s/n, 28260 Hoyo de Manzanares-Madrid, Spain
| | - Carmelina Sanz-Velasco
- University Health Center Sector III, Madrid Health Service, Av. Juan Carlos I, 1, 28905 Getafe-Madrid, Spain
| | | | - Paula Simonaggio-Stancampiano
- Health Center San Martin de la Vega, Madrid Health Service, Av. Doce de Octubre, 6, 28330 San Martín de la Vega-Madrid, Spain
| | - María Pilar Cabello-Igual
- Health Center Parque Europa, Madrid Health Service, Pza. David Martín s/n, 28320 Pinto-Madrid, Spain
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Teixeira P, Pereira H, Monteiro S, Esgalhado G, Afonso RM, Loureiro M, Ferrão D, Garcia N. [The importance of biomedical indicators in sexual functioning in healthy Portuguese adults]. Rev Int Androl 2019; 17:15-23. [PMID: 30691587 DOI: 10.1016/j.androl.2017.12.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 12/30/2017] [Indexed: 01/05/2023]
Abstract
BACKGROUND The aim of this study was to investigate the influence of biomedical indicators, such as body mass index, blood glucose, total cholesterol, triglycerides, systolic blood pressure and diastolic blood pressure, on sexual functioning in Portuguese adults. METHODS The sample consisted of 225 healthy individuals (non-smokers, women not taking contraceptive pill), aged 18-89 years (mean = 41 years), of whom 107 were males and 117 females. A Sociodemographic Questionnaire, the Portuguese version of the Massachusetts General Hospital Sexual Functioning Questionnaire (MGH-SFQ) and biomedical indicators measurement devices were applied. RESULTS 59.6% (N = 134) of the participants presented levels for global sexual functioning below the expected values. Men scored better overall sexual functioning when compared to women, as well as the group of younger participants. Significant correlational values between BMI (r = -253, p <.001), glycemic index (r = -.230, p <.001), total cholesterol (r = -144, p < .05) and sexual functioning were obtained. The hierarchical regression model allowed to demonstrate the mediating effect of the biomedical variables on sexual functioning, explaining 31% (r2 = .31; p <.001) of the total variance. DISCUSSION AND CONCLUSIONS This research makes it possible to highlight the importance of biomedical indicators in sexual functioning, helping professionals working in this area to be aware of how biomedical contexts interfere with sexual expression.
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Affiliation(s)
- Paula Teixeira
- Universidade da Beira Interior, Covilhã, Portugal; Universidade da Beira Interior, Departamento de Psicologia e Educação, Covilhã, Portugal.
| | - Henrique Pereira
- Universidade da Beira Interior, Covilhã, Portugal; Universidade da Beira Interior, Departamento de Psicologia e Educação, Covilhã, Portugal; Universidade da Beira Interior, Centro de Investigação em Ciências da Saúde (CICS), Covilhã, Portugal
| | - Samuel Monteiro
- Universidade da Beira Interior, Covilhã, Portugal; Universidade da Beira Interior, Departamento de Psicologia e Educação, Covilhã, Portugal
| | - Graça Esgalhado
- Universidade da Beira Interior, Covilhã, Portugal; Universidade da Beira Interior, Departamento de Psicologia e Educação, Covilhã, Portugal
| | - Rosa Marina Afonso
- Universidade da Beira Interior, Covilhã, Portugal; Universidade da Beira Interior, Departamento de Psicologia e Educação, Covilhã, Portugal
| | - Manuel Loureiro
- Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, Vila Real, Portugal
| | - Delfina Ferrão
- Agrupamento de Centros de Saúde Cova da Beira, Centro de Saúde da Covilhã, Covilhã, Portugal
| | - Nuno Garcia
- Universidade da Beira Interior, Covilhã, Portugal; Universidade da Beira Interior, Departamento de Informática, Covilhã, Portugal
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Song WH, Park J, Yoo S, Oh S, Cho SY, Cho MC, Jeong H, Son H. Changes in the Prevalence and Risk Factors of Erectile Dysfunction during a Decade: The Korean Internet Sexuality Survey (KISS), a 10-Year-Interval Web-Based Survey. World J Mens Health 2018; 37:199-209. [PMID: 30588782 PMCID: PMC6479078 DOI: 10.5534/wjmh.180054] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Revised: 09/15/2018] [Accepted: 09/17/2018] [Indexed: 01/23/2023] Open
Abstract
Purpose Although the prevalence of erectile dysfunction (ED) can be affected by social changes, this association has not been well evaluated. We aimed to evaluate the prevalence and risk factors of ED through a 10-year-interval web-based survey using the previous database of same group of panels, with same methodology. Materials and Methods We sent e-mails and surveyed the panels registered in the Internet survey agency. Results In total, 900 participants were recruited in 2016. The age-adjusted overall prevalences of self-reported ED (self-ED) and International Index of Erectile Function-5-assessed ED (IIEF-5-ED; score ≤21) in the 2016 study were 3.2% and 44.8%, respectively, which were lower than the prevalences of 8.1% (p=0.036) and 51.4% (p=0.323), respectively, in the 2006 study. The risk factors of IIEF-5-ED in their 20s and 30s in 2016 were psycho-social factors such as depression, low frequency of conversation about sex with sexual partner. The risk factors of IIEF-5-ED in their 40s to 60s in 2016 were organic factors, such as hypertension, diabetes mellitus, smoking, alcohol use, and self-reported premature ejaculation. Conclusions Although the age-adjusted overall prevalence of self-ED has decreased during a decade, there was no difference in the age-adjusted overall prevalence of IIEF-5-ED. Psycho-social support may be important for young men with ED and overall healthcare can be helpful for elderly men with ED.
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Affiliation(s)
- Won Hoon Song
- Department of Urology, Seoul National University College of Medicine, Seoul, Korea
| | - Juhyun Park
- Department of Urology, Seoul National University College of Medicine, Seoul, Korea.,Department of Urology, SMG-SNU Boramae Medical Center, Seoul, Korea
| | - Sangjun Yoo
- Department of Urology, SMG-SNU Boramae Medical Center, Seoul, Korea
| | - Sohee Oh
- Department of Biostatistics, SMG-SNU Boramae Medical Center, Seoul, Korea
| | - Sung Yong Cho
- Department of Urology, SMG-SNU Boramae Medical Center, Seoul, Korea
| | - Min Chul Cho
- Department of Urology, SMG-SNU Boramae Medical Center, Seoul, Korea
| | - Hyeon Jeong
- Department of Urology, Seoul National University College of Medicine, Seoul, Korea.,Department of Urology, SMG-SNU Boramae Medical Center, Seoul, Korea
| | - Hwancheol Son
- Department of Urology, Seoul National University College of Medicine, Seoul, Korea.,Department of Urology, SMG-SNU Boramae Medical Center, Seoul, Korea.
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Gur S, Abdel-Mageed AB, Sikka SC, Hellstrom WJG. Advances in stem cell therapy for erectile dysfunction. Expert Opin Biol Ther 2018; 18:1137-1150. [PMID: 30301368 DOI: 10.1080/14712598.2018.1534955] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Stem cell (SC) application is a promising area of research in regenerative medicine, with the potential to treat, prevent, and cure disease. In recent years, the number of studies focusing on SCs for the treatment of erectile dysfunction (ED) and other sexual dysfunctions has increased significantly. AREAS COVERED This review includes critical ED targets and preclinical studies, including the use of SCs and animal models in diabetes, aging, cavernous nerve injury, and Peyronie's disease. A literature search was performed on PubMed for English articles. EXPERT OPINION Combination treatment offers better results than monotherapy to improve pathological changes in diabetic ED. Regenerative medicine is a promising approach for the maintenance of sexual health and erectile function later in life. Cavernous nerve regeneration and vascular recovery employing SC treatment may be focused on radical prostatectomy-induced ED. Notwithstanding, there are a number of hurdles to overcome before SC-based therapies for ED are considered in clinical settings. Paracrine action, not cellular differentiation, appears to be the principal mechanism of action underlying SC treatment of ED. Intracavernosal injection of a single SC type should be the choice protocol for future clinical trials.
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Affiliation(s)
- Serap Gur
- a Department of Urology , Tulane University Health Sciences Center , New Orleans , LA , USA.,b Department of Pharmacology, Faculty of Pharmacy , Ankara University , Ankara , Turkey
| | - Asim B Abdel-Mageed
- a Department of Urology , Tulane University Health Sciences Center , New Orleans , LA , USA
| | - Suresh C Sikka
- a Department of Urology , Tulane University Health Sciences Center , New Orleans , LA , USA
| | - Wayne J G Hellstrom
- a Department of Urology , Tulane University Health Sciences Center , New Orleans , LA , USA
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Montgomery J, Madsen C, Leroux T, Koehlmoos TP. Utilization and prescription patterns of phosphidiesterase-5 inhibitor medications in the United States military health system. Int J Impot Res 2018; 30:300-305. [DOI: 10.1038/s41443-018-0037-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 02/27/2018] [Accepted: 04/22/2018] [Indexed: 11/09/2022]
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Goldstein I, Chambers R, Tang W, Stecher V, Hassan T. Real-world observational results from a database of 48 million men in the United States: Relationship of cardiovascular disease, diabetes mellitus and depression with age and erectile dysfunction. Int J Clin Pract 2018; 72:e13078. [PMID: 29569323 DOI: 10.1111/ijcp.13078] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Accepted: 02/16/2018] [Indexed: 11/28/2022] Open
Abstract
AIMS To evaluate the relationship of comorbidities (cardiovascular disease [CVD], diabetes mellitus [DM] and depression) with erectile dysfunction (ED) and age using real-world claims data from 48 million men in the United States. METHODS This was a cross-sectional, non-interventional study in men aged ≥18 years using data from the Truven Health MarketScan® and Medicare Supplemental Research Databases from January 2010 to December 2015, with an observational period of January 2011 to December 2014 to allow for 12 months pre- and post-index. Comorbidity rate was compared between ED and non-ED groups by age using the χ2 (bivariate) test. Comorbidity relationship to ED after controlling for categorical variables was assessed using logistic regression analysis. RESULTS In all, 48 004 379 men were in the database. Of the 9 839 578 who met the inclusion criteria, 573 313 (6%) were ED patients and 9 266 265 (94%) were non-ED patients. ED diagnosis increased decade to decade from 18-29 years to 50-59 years but decreased from 60-69 years to ≥90 years. ED patients had a higher prevalence of CVD, DM and depression than non-ED patients in all periods (P < .0001). After controlling for potential demographic and baseline confounders, the association between ED and CVD, DM and depression remained significant for each age group beginning at 30-39 years (P < .0001). DISCUSSION Conversations with patients concerning ED should be comprehensive regardless of patient age, in particular in those who have CVD, DM and/or depression. CONCLUSIONS In the real-world setting, ED diagnosis was associated with CVD, DM and depression across age groups, suggesting a need for inquiry about the potential for comorbidities among these men as a preventative measure against potentially serious future events.
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Affiliation(s)
| | | | - WingYu Tang
- Patient & Health Impact, Pfizer Inc, New York, NY, USA
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Sensory Dysfunction and Sexuality in the U.S. Population of Older Adults. J Sex Med 2018; 15:502-509. [PMID: 29501426 DOI: 10.1016/j.jsxm.2018.01.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 01/17/2018] [Accepted: 01/24/2018] [Indexed: 12/24/2022]
Abstract
BACKGROUND The sexual experience is shaped by sensory function; with aging, sensory dysfunction may interfere with sexuality and sexual behavior between partners. Specifically, older adults with age-related sensory dysfunction may have less sexual activity than those with better sensory function. In addition, since sexual desire and attraction rests in part upon sensory function, sensory dysfunction may also be associated with less sexual motivation. AIM To test the association between sexual activity and motivation in older adults and their sensory dysfunction. METHODS Sensory dysfunction was measured both by global sensory impairment (a validated measure of dysfunction shared among the 5 classic senses: olfaction, vision, taste, touch, hearing) and by total sensory burden (cumulative sensory loss). Sexual activity was quantified by frequency and type of sexual behavior. Sexual motivation was measured by the frequency of sexual ideation and the importance of sex to the respondent. We used cross-sectional data from a nationally representative sample of community-dwelling older adults (aged 57-85 years) in the United States (National Social Life, Health, and Aging Project, N = 3,005) in logistic regression analyses. OUTCOMES Sexual activity, sexual motivation, and satisfaction with the sexual relationship were self-reported. RESULTS Older adults with sensory dysfunction were less likely to be sexually active-an association that persisted when accounting for other factors that also affected sexual activity (age, gender, partnered status, mental and physical health, and relationship satisfaction). Nonetheless, sensory dysfunction did not impair sexual motivation, nor affect the physical and emotional satisfaction with the sexual relationship. Among currently sexually active older adults, sensory dysfunction did not affect the frequency of sex or the type of sexual activity (foreplay, vaginal intercourse, or oral sex). These results were the same for 2 different measures of sensory dysfunction. CLINICAL TRANSLATION This is the first nationally representative study of sexuality and multisensory dysfunction in community-dwelling older adults. 4 of the 5 classic senses were measured with objective tests, and hearing was rated by interviewers in the context of their conversation. Medical and health care interventions that can reduce the burden of sensory dysfunction may improve older adults' sexual experience. CONCLUSIONS Sensory dysfunction is associated with sexual inactivity, but not with sexual motivation. Among those who are sexually active, sensory dysfunction did not interfere with sexual expression. Improving the sexual experience of older adults requires a focus on sensory dysfunction as an impediment to sexual activity given that older adults remain sexually motivated. Zhong S, Pinto JM, Wroblewski KE, et al. Sensory Dysfunction and Sexuality in the U.S. Population of Older Adults. J Sex Med 2018;15:502-509.
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Wu F, Xiong ZQ, Mao SH, Hu JM, Wang JQ, Jiang HW, Ding Q. Aldosterone induces inflammatory cytokines in penile corpus cavernosum by activating the NF-κB pathway. Asian J Androl 2018; 20:24-29. [PMID: 28382926 PMCID: PMC5753550 DOI: 10.4103/aja.aja_8_17] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 01/09/2017] [Accepted: 02/06/2017] [Indexed: 01/14/2023] Open
Abstract
Emerging evidence indicates that aldosterone and mineralocorticoid receptors (MRs) are associated with the pathogenesis of erectile dysfunction. However, the molecular mechanisms remain largely unknown. In this study, freshly isolated penile corpus cavernosum tissue from rats was treated with aldosterone, with or without MRs inhibitors. Nuclear factor (NF)-kappa B (NF-κB) activity was evaluated by real-time quantitative PCR, luciferase assay, and immunoblot. The results demonstrated that mRNA levels of the NF-κB target genes, including inhibitor of NF-κB alpha (IκB-α), NF-κB1, tumor necrosis factor-alpha (TNF-α), and interleukin 6 (IL-6), were higher after aldosterone treatment. Accordingly, phosphorylation of p65/RelA, IκB-α, and inhibitor of NF-κB kinase-β was markedly increased by aldosterone. Furthermore, knockdown of MRs prevented activation of the NF-κB canonical pathway by aldosterone. Consistent with this finding, ectopic overexpression of MRs enhanced the transcriptional activation of NF-κB by aldosterone. More importantly, the MRs antagonist, spironolactone blocked aldosterone-mediated activation of the canonical NF-κB pathway. In conclusion, aldosterone has an inflammatory effect in the corpus cavernosum penis, inducing NF-κB activation via an MRs-dependent pathway, which may be prevented by selective MRs antagonists. These data reveal the possible role of aldosterone in erectile dysfunction as well as its potential as a novel pharmacologic target for treatment.
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Affiliation(s)
- Fei Wu
- Department of Urology, Fudan Institute of Urology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Zu-Quan Xiong
- Department of Urology, Fudan Institute of Urology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Shan-Hua Mao
- Department of Urology, Fudan Institute of Urology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Ji-Meng Hu
- Department of Urology, Fudan Institute of Urology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Jian-Qing Wang
- Department of Urology, Fudan Institute of Urology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Hao-Wen Jiang
- Department of Urology, Fudan Institute of Urology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Qiang Ding
- Department of Urology, Fudan Institute of Urology, Huashan Hospital, Fudan University, Shanghai 200040, China
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Comerma-Steffensen SG, Carvacho I, Hedegaard ER, Simonsen U. Small and Intermediate Calcium-Activated Potassium Channel Openers Improve Rat Endothelial and Erectile Function. Front Pharmacol 2017; 8:660. [PMID: 28993731 PMCID: PMC5619997 DOI: 10.3389/fphar.2017.00660] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 09/05/2017] [Indexed: 12/13/2022] Open
Abstract
Modulation of endothelial calcium-activated potassium (KCa) channels has been proposed as an approach to restore endothelial function. The present study investigated whether novel openers of KCa channels with small (KCa2.x) and intermediate (KCa3.1) conductance, NS309 and NS4591, improve endothelium-dependent relaxation and erectile function. Rat corpus cavernosum (CC) strips were mounted for isometric tension recording and processed for immunoblotting. Mean arterial pressure (MAP), intracavernosal pressure (ICP), and electrocardiographic (ECG) measurements were conducted in anesthetized rats. Immunoblotting revealed the presence of KCa2.3 and large KCa conductance (KCa1.1) channels in the corpus cavernosum. NS309 and NS4591 increased current in CC endothelial cells in whole cell patch clamp experiments. Relaxation induced by NS309 (<1 μM) was inhibited by endothelial cell removal and high extracellular potassium. An inhibitor of nitric oxide (NO) synthase, and blockers of KCa2.x and KCa1.1 channels, apamin and iberiotoxin also inhibited NS309 relaxation. Incubation with NS309 (0.5 μM) markedly enhanced acetylcholine relaxation. Basal erectile function (ICP/MAP) increased during administration of NS309. Increases in ICP/MAP after cavernous nerve stimulation with NS309 were unchanged, whereas NS4591 significantly improved erectile function. Administration of NS309 and NS4591 caused small changes in the electrocardiogram, but neither arrhythmic events nor prolongation of the QTc interval were observed. The present study suggests that openers of KCa2.x and KCa3.1 channels improve endothelial and erectile function. The effects of NS309 and NS4591 on heart rate and ECG are small, but will require additional safety studies before evaluating whether activation of KCa2.3 channels has a potential for treatment of erectile dysfunction.
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Affiliation(s)
- Simon G. Comerma-Steffensen
- Department of Biomedicine, Pulmonary and Cardiovascular Pharmacology, Aarhus UniversityAarhus, Denmark
- Animal Physiology, Department of Biomedical Sciences, Veterinary Sciences Faculty, Central University of VenezuelaMaracay, Venezuela
| | - Ingrid Carvacho
- Department of Biomedicine, Pulmonary and Cardiovascular Pharmacology, Aarhus UniversityAarhus, Denmark
- Department of Biology and Chemistry, Faculty of Basic Sciences, Universidad Católica del MauleTalca, Chile
| | - Elise R. Hedegaard
- Department of Biomedicine, Pulmonary and Cardiovascular Pharmacology, Aarhus UniversityAarhus, Denmark
| | - Ulf Simonsen
- Department of Biomedicine, Pulmonary and Cardiovascular Pharmacology, Aarhus UniversityAarhus, Denmark
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Patel JP, Lee EH, Mena-Hurtado CI, Walker CN. Evaluation and Management of Erectile Dysfunction in the Hypertensive Patient. Curr Cardiol Rep 2017; 19:89. [DOI: 10.1007/s11886-017-0889-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Madbouly K, AlHajeri D, Habous M, Binsaleh S. Association of the modified frailty index with adverse outcomes after penile prosthesis implantation. Aging Male 2017; 20:119-124. [PMID: 28590832 DOI: 10.1080/13685538.2017.1292499] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVES To investigate frailty as a predictor of surgical outcome in elderly patients undergoing penile prosthesis implantation. MATERIAL AND METHODS A total of 54 elderly patients, above 60 years of age, underwent penile prosthesis implantation between 2012 and 2014. Their data were collected and retrospectively analyzed. A modified frailty index (mFI) was calculated for each patient based on 11 risk factors from the Canadian Study of Health and Aging Frailty Index. The 1-year adverse outcomes were correlated with mFI, patients' and procedure's risk factors. RESULTS Mean age was 64.9 ± 5.2 years. No mortality was reported in our patients, however, one-year adverse outcomes were encountered in 43 (79.6%) patients. Among all studied variables, the 1-year adverse outcomes was not significantly association with mFI, but with preoperative glycosylated hemoglobin A1c (HbA1c) (p = 0.031) and associated Peyronie's disease (PD) (p = 0.000). HbA1c, dyslipidemia, hypertension, PD and duration of the procedure were predictive of infection complications (p < 0.05). Only PD and HbA1c sustained an independent significant impact. CONCLUSIONS mFI is not a predictive of post-penile prosthesis implantation adverse outcomes in elderly patients with impotence. Degree of diabetic control and association with PD was associated with the 1-year adverse outcomes and infection complications.
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Affiliation(s)
- Khaled Madbouly
- a Department of Urology , Prince Mohammed Bin Abdulaziz Hospital , Riyadh , Saudi Arabia
| | - Dulaim AlHajeri
- b Division of Urology , Department of Surgery, Faculty of Medicine, King Saud University , Riyadh , Saudi Arabia , and
| | - Mohamad Habous
- c Urology Department, Elaj Medical Group , Jeddah , Saudi Arabia
| | - Saleh Binsaleh
- b Division of Urology , Department of Surgery, Faculty of Medicine, King Saud University , Riyadh , Saudi Arabia , and
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Mulhall JP, Luo X, Zou KH, Stecher V, Galaznik A. Relationship between age and erectile dysfunction diagnosis or treatment using real-world observational data in the USA. Int J Clin Pract 2016; 70:1012-1018. [PMID: 28032424 PMCID: PMC5540144 DOI: 10.1111/ijcp.12908] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Accepted: 10/07/2016] [Indexed: 01/05/2023] Open
Abstract
AIMS With self-reporting of erectile dysfunction (ED) in population-based surveys, men with ED may not represent men who are bothered sufficiently to seek an ED diagnosis and treatment. We used real-world observational data to assess: 1) the prevalence of ED diagnosis or treatment by age subgroups; and 2) the relationship of age with ED diagnosis or treatment after controlling for ED-related comorbidities in the USA. METHODS This cross-sectional study used de-identified claims data (MarketScan® databases; primary analysis). Sensitivity analysis was conducted using electronic health records (Humedica® database). Inclusion criteria were men aged ≥18 years with a 360-day continuous enrollment before the index date. We assessed the prevalence of ED diagnosis or phosphodiesterase type 5 inhibitor (PDE5I) prescription by age and the risk for ED diagnosis or treatment by age after controlling for comorbidities (hypertension, other cardiovascular disease, diabetes mellitus, depression and benign prostatic hyperplasia). RESULTS Of 19,833,939 men meeting inclusion criteria in the primary analysis, only 1 108 842 (5.6%) had an ED diagnosis or PDE5I prescription (mean [SD] age: 55.2 [11.2] years). Prevalence of ED diagnosis or treatment increased from age 18-29 years (0.4%) to 60-69 years (11.5%), then decreased in the seventh (11.0%), eighth (4.6%), and ninth (0.9%) decades. Men with ED diagnosis or treatment had a higher prevalence of any comorbidity (63.1% vs 29.3% for men without ED) and of each comorbid condition. In multivariate analyses, age was an independent risk factor for ED diagnosis or treatment. Sensitivity analysis provided consistent results. CONCLUSIONS In a real-world setting in the USA, the prevalence of ED diagnosis or PDE5I treatment is generally low, increases with age, decreases in very old men, and is associated with increased prevalence of comorbidities. Age is an independent risk factor for ED diagnosis or treatment after controlling for comorbidities.
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Affiliation(s)
- John P. Mulhall
- Memorial Sloan Kettering Cancer Center Urology Service, Department of Surgery, New York, NY, USA
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Yuan JQ, Mao C, Yang ZY, Fu XH, Wong SY, Tang JL. A meta-regression evaluating the effectiveness and prognostic factors of oral phosphodiesterase type 5 inhibitors for the treatment of erectile dysfunction. Asian J Androl 2016; 18:60-5. [PMID: 25966626 PMCID: PMC4736358 DOI: 10.4103/1008-682x.154304] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
The effectiveness of phosphodiesterase type 5 inhibitors (PDE5-Is) for erectile dysfunction (ED) varies considerably among trials, but available studies investigating the factors that affect the effectiveness are few and findings are not consistent. A systematic search was performed in PubMed, Cochrane Library, and EMBASE to identify randomized controlled trials comparing PDE5-Is with placebo for the treatment of ED. The methodological quality of included studies was assessed by the Cochrane Collaboration's tool for assessing risk of bias. The associations between prespecified study-level factors and effectiveness were tested by a random effects meta-regression model. This study included 93 trials with 26 139 patients. When all PDE5-Is were grouped together, Caucasian ethnicity was associated with 15.636% (95% confidence interval [CI]: 0.858% to 32.579%) increase in risk ratio (RR) for Global Assessment Questionnaire question-1 (GAQ-1), and 1.473 (95% CI: 0.406 to 2.338) score increase in mean difference (MD) for posttreatment International Index of Erectile Function-Erectile Function domain score (IIEF-EF), compared to Asian ethnicity. A one-score increase in baseline IIEF-EF was associated with −5.635% (95% CI: −9.120% to −2.017%) reduction in RR for GAQ-1, and −0.229 (95% CI: −0.425 to −0.042) score decrease in MD for posttreatment IIEF-EF. In conclusion, PDE5-Is are more effective in Caucasians than Asians, and in patients with more severe ED.
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Affiliation(s)
| | - Chen Mao
- Division of Epidemiology, School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong; Shenzhen Municipal Key Laboratory for Health Risk Analysis, Shenzhen Research Institute of The Chinese University of Hong Kong, Shenzhen, 518055, China
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Mohamed ER, Hammady AR, Eldahshoury MZ, Elsharkawi AM, Riad AM, Elmogazy HM, Hussien MM, Gamal WM. Surgical outcomes and complications of Tube® (Promedon) malleable penile prostheses in diabetic versus non-diabetic patients with erectile dysfunction. Arab J Urol 2016; 14:305-311. [PMID: 27900222 PMCID: PMC5122751 DOI: 10.1016/j.aju.2016.07.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 07/12/2016] [Accepted: 07/14/2016] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To evaluate surgical outcome, complications, and patients satisfaction with the Tube® (Promedon, Cordoba, Argentina) malleable penile prosthesis in diabetic and non-diabetic patients with refractory erectile dysfunction (ED). PATIENTS AND METHODS The records of 128 eligible patients who received Tube malleable penile prostheses at our institute between September 2008 and October 2015 were reviewed. RESULTS Of the 128 patients, who received Tube penile prostheses at our institute, 53 were diabetics and 75 were non-diabetics. Both groups of patients were comparable for mean age, education level, marital status, hospital stay, time to commencing sexual intercourse, and median follow-up. Complications included: inter-corporeal septal perforation (2.3%), glanular urethral injury (1.5%), acute urinary retention (3.9%), superficial wound infection (7%), penile discomfort (9.4%), and penile prostheses infection (5.5%). Moreover, 3.9% developed atrophy of the cavernosal tissue, 5.5% experienced bad cosmesis, 6.3% experienced ejaculatory disorders, and 2.3% developed bladder calculi. In all, 13 prostheses (9.4%) were removed, seven of them due to infection, three on the patients' demand and three due to mechanical failure. The satisfaction rates with the prostheses were 77.3% and 79.4% in the diabetic and non-diabetic patients, respectively; with an overall satisfaction rate of 78.5%. There was no significant difference in the complication rate or prostheses infection between diabetic and non-diabetic patients. CONCLUSION Tube malleable penile prostheses are associated with low complication and high satisfaction rates. There was no significant difference in the complication rate or prostheses infection between diabetic and non-diabetic patients. A prospective comparative study with a large number of patients is recommended.
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Affiliation(s)
| | | | | | | | - Ahmed Mahmoud Riad
- Urology Department, Sohag Faculty of Medicine, Sohag University, Sohag, Egypt
| | | | | | - Wael Mohamed Gamal
- Urology Department, Sohag Faculty of Medicine, Sohag University, Sohag, Egypt
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Ning L, Yang L. Hypertension might be a risk factor for erectile dysfunction: a meta-analysis. Andrologia 2016; 49. [PMID: 27491642 DOI: 10.1111/and.12644] [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: 04/20/2016] [Indexed: 12/21/2022] Open
Abstract
The study aimed to evaluate whether hypertension was a risk factor for erectile dysfunction (ED). Databases including PubMed and Embase were retrieved to identify studies related to hypertension in ED patients. Odds ratio (OR) and 95% confidence interval (CI) were used as the effect size. Subgroup analyses stratified by total number of enrolled subjects and research regions were performed. Sensitivity analysis was performed by removing a single study at one time. Egger's test was used to evaluate the publication bias. Totally, 40 studies including 121,641 subjects were included in the meta-analysis. As a result, hypertension was closely related to ED (OR = 1.74, 95% CI, 0.63-0.80, p < .01). Subgroup analysis indicated hypertension was the risk factor for ED whatever the participants numbers. When stratified by different regions, hypertension was a risk factor for ED in Africa (OR = 3.35, 95% CI, 1.45-7.77, p < .01), Americas (OR = 1.97, 95% CI, 1.68-2.31, p < 0.01), Asia (OR = 1.46, 95% CI, 1.16-1.84, p < .01) and Europe (OR = 1.83, 95% CI, 1.34-2.49, p < .01), but not in Australia. Hypertension may be a potential risk factor for ED.
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Affiliation(s)
- L Ning
- Department of Urology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - L Yang
- Department of Urology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
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Significant improvement of erectile function after Roux-en-Y gastric bypass surgery in obese Chinese men with erectile dysfunction. Obes Surg 2015; 25:838-44. [PMID: 25361762 DOI: 10.1007/s11695-014-1465-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND We aimed to examine the effect of Roux-en-Y gastric bypass surgery (RYGB) on erectile dysfunction (ED), cavernosal morphological vasculopathy, and carotid wall alterations in severely obese Chinese men. METHODS We performed a retrospective cohort study of 39 obese men with ED who underwent RYGB between 2011 and 2012. Erectile function was assessed by the International Index of Erectile Function-5 (IIEF-5) before and 1 year after surgery. Intima-media thickness of carotid and cavernosal arteries and cavernosal peak systolic velocity (PSV) were investigated by color Doppler ultrasound. Endothelial function was assessed with the L-arginine test. RESULTS Eighteen (46.2%) men had cavernosal vasculopathy and 21 (53.8%) had carotid vasculopathy before surgery, and these proportions decreased to 15.4% and 23.1% after surgery, respectively. There was a significant improvement in carotid and cavernosal intima-media thickness postoperatively. IIEF-5 (17.3 to 23.8, P < 0.05), PSV (23 to 37, P < 0.05), and endothelial scores (6.1 to 8.2, P < 0.05) were all improved after RYGB. The increase in endothelial function scores was positively associated with changes in pre- to postoperative IIEF-5 scores (r = 0.438, P = 0.017). Younger age, being married, and lower preoperative IIEF-5 scores were independently related to greater improvement in erectile function. CONCLUSIONS ED can be relieved after RYGB in obese Chinese patients, accompanied by the improvement of cavernosal morphological vasculopathy and carotid wall alterations. Changes in endothelial function may contribute to this improvement, while preoperative body mass index and the amount of weight loss do not.
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Simon RM, Howard L, Zapata D, Frank J, Freedland SJ, Vidal AC. The Association of Exercise with Both Erectile and Sexual Function in Black and White Men. J Sex Med 2015; 12:1202-10. [DOI: 10.1111/jsm.12869] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Alwaal A, Hussein AA, Lin CS, Lue TF. Prospects of stem cell treatment in benign urological diseases. Korean J Urol 2015; 56:257-65. [PMID: 25874038 PMCID: PMC4392024 DOI: 10.4111/kju.2015.56.4.257] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Accepted: 02/23/2015] [Indexed: 12/15/2022] Open
Abstract
Stem cells (SCs) are undifferentiated cells that are capable of self-renewal and differentiation and that therefore contribute to the renewal and repair of tissues. Their capacity for division, differentiation, and tissue regeneration is highly dependent on the surrounding environment. Several preclinical and clinical studies have utilized SCs in urological disorders. In this article, we review the current status of SC use in benign urological diseases (erectile dysfunction, Peyronie disease, infertility, and urinary incontinence), and we summarize the results of the preclinical and clinical trials that have been conducted.
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Affiliation(s)
- Amjad Alwaal
- Department of Urology, University of California, San Francisco, CA, USA
- Department of Urology, King Abdul Aziz University, Jeddah, Saudi Arabia
| | - Ahmed A. Hussein
- Department of Urology, University of California, San Francisco, CA, USA
- Department of Urology, Cairo University, Cairo, Egypt
| | - Ching-Shwun Lin
- Department of Urology, University of California, San Francisco, CA, USA
| | - Tom F. Lue
- Department of Urology, University of California, San Francisco, CA, USA
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49
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Stem cell treatment of erectile dysfunction. Adv Drug Deliv Rev 2015; 82-83:137-44. [PMID: 25446142 DOI: 10.1016/j.addr.2014.11.012] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2014] [Revised: 09/09/2014] [Accepted: 11/08/2014] [Indexed: 12/31/2022]
Abstract
Erectile Dysfunction (ED) is a common disease that typically affects older men. While oral type-5 phosphodieserase inhibitors (PDE5Is) represent a successful first-line therapy, many patients do not respond to this treatment leading researchers to look for alternative treatment modalities. Stem cell (SC) therapy is a promising new frontier for the treatment of those patients and many studies demonstrated its therapeutic effects. In this article, using a Medline database search of all relevant articles, we present a summary of the scientific principles behind SCs and their use for treatment of ED. We discuss specifically the different types of SCs used in ED, the methods of delivery tested, and the methods attempted to enhance SC therapy effect. In addition, we review the current preclinical literature on SC therapy for ED and present a summary of its findings in addition to the single clinical trial published.
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Yang X, Rossi P, Jani AB, Mao H, Ogunleye T, Curran WJ, Liu T. A 3D Neurovascular Bundles Segmentation Method based on MR-TRUS Deformable Registration. PROCEEDINGS OF SPIE--THE INTERNATIONAL SOCIETY FOR OPTICAL ENGINEERING 2015; 9413:941319. [PMID: 31467458 PMCID: PMC6715139 DOI: 10.1117/12.2077828] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
In this paper, we propose a 3D neurovascular bundles (NVB) segmentation method for ultrasound (US) image by integrating MR and transrectal ultrasound (TRUS) images through MR-TRUS deformable registration. First, 3D NVB was contoured by a physician in MR images, and the 3D MR-defined NVB was then transformed into US images using a MR-TRUS registration method, which models the prostate tissue as an elastic material, and jointly estimates the boundary deformation and the volumetric deformations under the elastic constraint. This technique was validated with a clinical study of 6 patients undergoing radiation therapy (RT) treatment for prostate cancer. The accuracy of our approach was assessed through the locations of landmarks, as well as previous ultrasound Doppler images of patients. MR-TRUS registration was successfully performed for all patients. The mean displacement of the landmarks between the post-registration MR and TRUS images was less than 2 mm, and the average NVB volume Dice Overlap Coefficient was over 89%. This NVB segmentation technique could be a useful tool as we try to spare the NVB in prostate RT, monitor NVB response to RT, and potentially improve post-RT potency outcomes.
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Affiliation(s)
- Xiaofeng Yang
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA 30322
| | - Peter Rossi
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA 30322
| | - Ashesh B. Jani
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA 30322
| | - Hui Mao
- Department of Radiology and Imaging Sciences and Winship Cancer Institute, Emory University, Atlanta, GA 30322
| | - Tomi Ogunleye
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA 30322
| | - Walter J. Curran
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA 30322
| | - Tian Liu
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA 30322
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