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Rezaiezadeh H, Ranjbar Tavakoli M, Langarizadeh MA, Saeedi Garaghani Z, Karami-Mohajeri S. Unveiling the science behind erectile dysfunction topical therapy: investigating transdermal papaverine as a novel treatment approach. Sex Med Rev 2024:qeae059. [PMID: 39173091 DOI: 10.1093/sxmrev/qeae059] [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: 02/06/2024] [Revised: 06/29/2024] [Accepted: 08/03/2024] [Indexed: 08/24/2024]
Abstract
INTRODUCTION Erectile dysfunction is among the most prevalent urologic issues affecting men globally and is characterized by a high incidence rate. This condition significantly affects the quality of life of patients and their sexual partners. OBJECTIVES Due to the interactions, contraindications, and side effects associated with systemic drugs, recent research has increasingly focused on topical and transdermal medications for the treatment of erectile dysfunction. METHODS Based on previous studies, this article examines papaverine in terms of local effectiveness, methods of increasing therapeutic efficiency, possible local side effects, and evaluation of its various formulations. RESULTS Among these approaches, notable strategies include using novel formulations and nanoformulations as compared with classic ones, employing permeation enhancers, and combining treatments with other oral and topical drugs with synergistic mechanisms. These methods aim to improve transdermal papaverine's bioavailability and therapeutic efficacy while minimizing side effects and enhancing patient compliance. CONCLUSION Transdermal papaverine may not be as effective as its injectable form, but the treatment path is more pleasant, with less pain and fewer side effects for patients. For this reason, using solutions that remove the penile skin and fascial absorption barrier can be very effective.
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Affiliation(s)
- Hojjat Rezaiezadeh
- Student Research Committee, Faculty of Pharmacy, Kerman University of Medical Sciences, Kerman, Iran
- Department of Medicinal Chemistry, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Marziyeh Ranjbar Tavakoli
- Department of Medicinal Chemistry, Faculty of Pharmacy, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Amin Langarizadeh
- Department of Medicinal Chemistry, Faculty of Pharmacy, Kerman University of Medical Sciences, Kerman, Iran
| | | | - Somayyeh Karami-Mohajeri
- Department of Toxicology and Pharmacology, Faculty of Pharmacy, Kerman University of Medical Sciences, Kerman, Iran
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Sedaghat F, Kamona A. Inflatable Penile Prosthesis Complication in the Emergency Department. Healthcare (Basel) 2024; 12:964. [PMID: 38786376 PMCID: PMC11121266 DOI: 10.3390/healthcare12100964] [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: 04/10/2024] [Revised: 05/05/2024] [Accepted: 05/06/2024] [Indexed: 05/25/2024] Open
Abstract
Inflatable penile prostheses are a widely utilized treatment for erectile dysfunction. While MRI is the optimal imaging modality for patients with suspected implant complications, it is often unavailable in the acute setting. In light of these limitations, we present a case of urethral perforation by an implanted penile cylinder and its evaluation with contrast-enhanced computed tomography (CT) in an emergent setting.
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Affiliation(s)
- Farzad Sedaghat
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA;
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Anderson D, Laforge J, Ross MM, Vanlangendonck R, Hasoon J, Viswanath O, Kaye AD, Urits I. Male Sexual Dysfunction. Health Psychol Res 2022; 10:37533. [PMID: 35999971 PMCID: PMC9392840 DOI: 10.52965/001c.37533] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2023] Open
Abstract
Male sexual dysfunction is a series of conditions, most notably including erectile dysfunction (ED), Peyronie's disease (PD), and premature ejaculation (PE), defined by impaired sexual functioning. The prevalence of male sexual dysfunction increases with age and is relatively high with greater than 50% of men aged 40 to 70 describing some degree of erectile dysfunction. Risk factors for male sexual dysfunction include age, diabetes mellitus (DM), cancer, stroke, hypertension, penile trauma, depression, anxiety, and disturbance in central serotonin neurotransmission and 5-HT postsynaptic receptor functioning. Sexual questionnaires including the International Index of Erectile Dysfunction, Sexual Health Inventory for Men, and the Premature Ejaculation Diagnostic Tool are useful in screening for these disorders. Focused history and physical can establish diagnoses. For a condition to be diagnosed as male sexual dysfunction, the patient or their partner must view their sexual functioning as impaired. Treatment of male sexual dysfunction is etiology dependent. For ED, first-line therapy is a phosphodiesterase-5 inhibitor or mental health care for psychogenic ED. More complicated cases may be treated with injections, surgery, or shockwave therapy. PD is either treated with medications for pain management, collagenase clostridium histolyticum injection, corpoplasty, plication, or shockwave therapy. PE may be treated behaviorally or with SSRIs as first line medication.
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Affiliation(s)
| | - John Laforge
- Department of Anesthesiology, Louisiana State University Health Shreveport
| | - Maggie M Ross
- Department of Anesthesiology, Louisiana State University Health Shreveport
| | | | - Jamal Hasoon
- Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School
| | - Omar Viswanath
- Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School; Valley Anesthesiology and Pain Consultants, Envision Physician Services; Department of Anesthesiology, University of Arizona College of Medicine Phoenix; Department of Anesthesiology, Creighton University School of Medicine
| | - Alan D Kaye
- Department of Anesthesiology, Louisiana State University Health Shreveport
| | - Ivan Urits
- Department of Anesthesiology, Louisiana State University Health Shreveport; Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School
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Uski ACVR, Piccolo LM, Abud CP, Pedroso MHNI, Seidel Albuquerque K, Gomes NBN, Fernandes JDÁ. MRI of Penile Prostheses: The Challenge of Diagnosing Postsurgical Complications. Radiographics 2021; 42:159-175. [PMID: 34919468 DOI: 10.1148/rg.210075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Penile implants are surgically inserted devices used for the treatment of erectile disfunction. Improvements in surgical techniques and in the manufacturing of these implants have reduced the risk of intra- and postoperative complications and increased the popularity and use of this therapeutic option. Routine imaging is not recommended before penile prosthesis surgery. Malleable penile prostheses use noninflatable shafts inserted into each corpus cavernosum, which appear hypointense on T1- and T2-weighted MR images. Inflatable penile prostheses (IPPs) may consist of two or three parts and are composed of two cylinders inserted into the corpora cavernosa that are filled with a saline solution to produce rigidity. These appear homogeneously T2 hyperintense and the silicone-based covering of the cylinders appears T2 hypointense, thereby clearly delineating the cylinders. In the case of three-piece IPPs, a reservoir containing the fluid may be placed in the pelvis. The most frequent complications are related to infection and mechanical failure, the latter being more common in IPPs because more components are involved. Less common complications include malpositioning. Detection and management of postoperative complications are challenging, and MRI plays a crucial role as it permits evaluation of the positioning and configuration of the prosthesis components, as well as assists in functional evaluation of IPPs when images are obtained of both the flaccid and inflated states. ©RSNA, 2021.
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Affiliation(s)
- Ana Cláudia Vincenzi Raduan Uski
- From the Department of Diagnostic Imaging, Division of Abdominal Radiology, Hospital Santa Catarina, Rua Artur Prado 394, São Paulo, SP 01322-000, Brazil (A.C.V.R.U., L.M.P., J.d.Á.F.); and Department of Diagnostic Imaging, Division of Abdominal Radiology, Hospital Beneficência Portuguesa, São Paulo, Brazil (A.C.V.R.U., C.P.A., M.H.N.I.P., K.S.A., N.B.N.G.)
| | - Luciana Maksoud Piccolo
- From the Department of Diagnostic Imaging, Division of Abdominal Radiology, Hospital Santa Catarina, Rua Artur Prado 394, São Paulo, SP 01322-000, Brazil (A.C.V.R.U., L.M.P., J.d.Á.F.); and Department of Diagnostic Imaging, Division of Abdominal Radiology, Hospital Beneficência Portuguesa, São Paulo, Brazil (A.C.V.R.U., C.P.A., M.H.N.I.P., K.S.A., N.B.N.G.)
| | - Carolina Pereira Abud
- From the Department of Diagnostic Imaging, Division of Abdominal Radiology, Hospital Santa Catarina, Rua Artur Prado 394, São Paulo, SP 01322-000, Brazil (A.C.V.R.U., L.M.P., J.d.Á.F.); and Department of Diagnostic Imaging, Division of Abdominal Radiology, Hospital Beneficência Portuguesa, São Paulo, Brazil (A.C.V.R.U., C.P.A., M.H.N.I.P., K.S.A., N.B.N.G.)
| | - Maria Helena Naves Inácio Pedroso
- From the Department of Diagnostic Imaging, Division of Abdominal Radiology, Hospital Santa Catarina, Rua Artur Prado 394, São Paulo, SP 01322-000, Brazil (A.C.V.R.U., L.M.P., J.d.Á.F.); and Department of Diagnostic Imaging, Division of Abdominal Radiology, Hospital Beneficência Portuguesa, São Paulo, Brazil (A.C.V.R.U., C.P.A., M.H.N.I.P., K.S.A., N.B.N.G.)
| | - Kamila Seidel Albuquerque
- From the Department of Diagnostic Imaging, Division of Abdominal Radiology, Hospital Santa Catarina, Rua Artur Prado 394, São Paulo, SP 01322-000, Brazil (A.C.V.R.U., L.M.P., J.d.Á.F.); and Department of Diagnostic Imaging, Division of Abdominal Radiology, Hospital Beneficência Portuguesa, São Paulo, Brazil (A.C.V.R.U., C.P.A., M.H.N.I.P., K.S.A., N.B.N.G.)
| | - Natália Borges Nunes Gomes
- From the Department of Diagnostic Imaging, Division of Abdominal Radiology, Hospital Santa Catarina, Rua Artur Prado 394, São Paulo, SP 01322-000, Brazil (A.C.V.R.U., L.M.P., J.d.Á.F.); and Department of Diagnostic Imaging, Division of Abdominal Radiology, Hospital Beneficência Portuguesa, São Paulo, Brazil (A.C.V.R.U., C.P.A., M.H.N.I.P., K.S.A., N.B.N.G.)
| | - José de Ávila Fernandes
- From the Department of Diagnostic Imaging, Division of Abdominal Radiology, Hospital Santa Catarina, Rua Artur Prado 394, São Paulo, SP 01322-000, Brazil (A.C.V.R.U., L.M.P., J.d.Á.F.); and Department of Diagnostic Imaging, Division of Abdominal Radiology, Hospital Beneficência Portuguesa, São Paulo, Brazil (A.C.V.R.U., C.P.A., M.H.N.I.P., K.S.A., N.B.N.G.)
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Hill TD, Dowd-Arrow B, Ellison CG, Garcia-Alexander G, Bartkowski JP, Burdette AM. Sexual Dysfunction and Gun Ownership in America: When Hard Data Meet a Limp Theory. Am J Mens Health 2021; 15:15579883211044342. [PMID: 34521291 PMCID: PMC8447103 DOI: 10.1177/15579883211044342] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Although there has been no direct empirical evidence linking sexual dysfunction (SD) with gun ownership, speculation has been widespread and persistent for decades. In this paper, we formally examine the association between SD and gun ownership. Our primary hypothesis, derived from the psychosexual theory of gun ownership, asserts that men experiencing SD are more likely to personally own guns than other men. To test this hypothesis, we used recently collected data from the 2021 Crime, Health, and Politics Survey (CHAPS), a national probability sample of 780 men, and binary logistic regression to model gun ownership as a function of SD. Our key finding is that men experiencing SD are no more likely to own guns than men without SD. This interpretation was supported across several indicators of SD (performance anxiety, erection trouble, and ED medication) and gun ownership (personal gun ownership, purchasing a gun during the pandemic, and keeping a gun in one's bedroom). To our knowledge, we are the first to have directly tested the association between SD and gun ownership in America. Our findings are important because they contribute to our understanding of factors associated with gun ownership by challenging the belief that phallic symbolism and masculinity somehow drive men with SD to purchase guns. Our results also remind us of the perils of gun culture rhetoric, which, in this case, function to discredit gun owners and to further stigmatize men with ED. We conclude by calling for more evidence-based discussions of SD and guns in society.
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Affiliation(s)
- Terrence D Hill
- Department of Sociology, University of Texas at San Antonio, San Antonio, TX, USA
| | - Benjamin Dowd-Arrow
- Department of Sociology, Public Health Program, and Pepper Institute on Aging and Public Policy, Florida State University, Tallahassee, FL, USA
| | | | | | - John P Bartkowski
- Department of Sociology, University of Texas at San Antonio, San Antonio, TX, USA
| | - Amy M Burdette
- Department of Sociology, Public Health Program, and Pepper Institute on Aging and Public Policy, Florida State University, Tallahassee, FL, USA
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DeVries JJ, Zinmer KL, Walsh ME. Coexistence of vasculogenic erectile dysfunction and peripheral artery disease. JOURNAL OF VASCULAR NURSING 2020; 38:160-162. [PMID: 32950118 DOI: 10.1016/j.jvn.2020.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 07/22/2020] [Indexed: 11/24/2022]
Abstract
Erectile dysfunction (ED) is the most common sexual problem experienced by men. The incidence increases with age and causes significant negative impacts on self-esteem, intimate relationships, mental health, and may be a powerful prognostic indicator for underlying vascular disease. The purpose of this clinical column is to provide an overview of the pathophysiology, evaluation, and management of vasculogenic ED in a patient with peripheral artery disease. There is very little research focused on the coexistence of these two disease conditions.
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Affiliation(s)
- Jennifer J DeVries
- College of Nursing, University of Toledo, College of Nursing, Toledo, Ohio.
| | | | - M Eileen Walsh
- College of Nursing, University of Toledo, College of Nursing, Toledo, Ohio
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Moll FH, Löffelbein N, Halling T, Fangerau H. [Urology goes electric-electrotherapy : Modern therapies in the treatment of modern diseases-examples from urology]. Urologe A 2020; 59:326-340. [PMID: 32125448 PMCID: PMC7223190 DOI: 10.1007/s00120-020-01122-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The significance of electricity for medicine in the modern industrial age should not be underestimated. Particularly in connection with neurasthenia, electrotherapeutic approaches also experienced a boom for domestic use. Thus, electrotherapy reached urology just as it was becoming established as a medical specialty. We analyzed urological manuals and textbooks and objects in the W. P. Didusch Center for Urologic History and the Museum zur Geschichte der Urologie in Berlin to present the wide range of indications for electrotherapy in the emerging field of urology from impotence to urethral strictures and try to highlight the variability of their importance over time.
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Affiliation(s)
- F H Moll
- Institut für Geschichte Theorie und Ethik der Medizin, Heinrich-Heine-Universität, Düsseldorf, Deutschland.
- Urologische Klinik, Klinken der Stadt Köln gGmbH, Neufelder Straße 32, 51067, Köln, Deutschland.
- Museum, Bibliothek und Archiv, Deutsche Gesellschaft für Urologie e. V., Düsseldorf - Berlin, Deutschland.
| | - N Löffelbein
- Institut für Geschichte Theorie und Ethik der Medizin, Heinrich-Heine-Universität, Düsseldorf, Deutschland
| | - T Halling
- Institut für Geschichte Theorie und Ethik der Medizin, Heinrich-Heine-Universität, Düsseldorf, Deutschland
| | - H Fangerau
- Institut für Geschichte Theorie und Ethik der Medizin, Heinrich-Heine-Universität, Düsseldorf, Deutschland
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Krzastek SC, Smith R. An update on the best approaches to prevent complications in penile prosthesis recipients. Ther Adv Urol 2019; 11:1756287218818076. [PMID: 30671142 PMCID: PMC6329024 DOI: 10.1177/1756287218818076] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 11/17/2018] [Indexed: 12/18/2022] Open
Abstract
Placement of inflatable penile prosthesis is a procedure frequently performed for medication-refractory erectile dysfunction. Device implantation is not without risks, and as the frequency of device implantation increases, so do associated complications. The aim of this work is to review the most frequent operative complications associated with implantation of inflatable penile prostheses, and to review the best approaches to prevent these most common complications. Complications can broadly be categorized as infectious, noninfectious tissue-related, device-related, or related to patient and partner satisfaction. With understanding of these complications and ways to avoid them, as well as with appropriate patient selection and counseling, the inflatable penile prosthesis is an excellent option for the treatment of erectile dysfunction.
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Affiliation(s)
- Sarah C Krzastek
- Department of Urology, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Ryan Smith
- Department of Urology, University of Virginia School of Medicine, Charlottesville, VA 22908-0422, USA
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Scherzer ND, Dick B, Gabrielson AT, Alzweri LM, Hellstrom WJG. Penile Prosthesis Complications: Planning, Prevention, and Decision Making. Sex Med Rev 2018; 7:349-359. [PMID: 30033128 DOI: 10.1016/j.sxmr.2018.04.002] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 04/10/2018] [Accepted: 04/11/2018] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Inflatable penile prosthesis (IPP) is an established treatment option for men with erectile dysfunction (ED) refractory to medical therapy. Standardization of surgical technique and improvements in device construction have reduced all-cause complication rates to less than 5% in recent reports. Nonetheless, complications do exist, and can strongly impact morbidity and the quality of life of patients. Prosthetic urologists must be aware of the constellation of complications that can arise during or after IPP placement. AIM To provide a comprehensive review of penile prosthesis complications and discuss preventative strategies, as well as proper preoperative, intraoperative, and postoperative decision making. METHODS A review of the available literature from 1973 to 2018 was performed using PubMed with regard to IPP complications. MAIN OUTCOME MEASURES We reviewed publications that outlined preoperative planning strategies and the following IPP complications: hematoma, floppy glans, corporal fibrosis, corporal perforation and crossover, urethral injury, infection, impending erosion, and glandular ischemia. RESULTS Careful patient and device selection, setting realistic expectations of postsurgical outcomes, and adherence to a perioperative checklist is essential in the preoperative period. Intraoperatively, anticipate corporal fibrosis situations and always dilate laterally during corporal passage to reduce the risk of crossover and urethral injury. Limit perioperative antiplatelet therapy, apply compressive dressing, use a closed suction drain if indicated, and leave the device partially inflated postoperatively to reduce risk of hematoma. After surgery, monitor patients for potential complications that may warrant device explantation or salvage: IPP infection, glans ischemia, and impending erosion. CONCLUSIONS By using evidence and expert opinion-based decision-making strategies in the preoperative, intraoperative, and postoperative period of IPP placement, surgeons can reduce the risk of complications and dissatisfaction, even in ED patients with multiple comorbid conditions. Scherzer ND, Dick B, Gabrielson AT, et al. Penile Prosthesis Complications: Planning, Prevention, and Decision Making. Sex Med Rev 2019;7:349-359.
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Affiliation(s)
- Nickolas D Scherzer
- Tulane University School of Medicine, Department of Urology, New Orleans, LA, USA
| | - Brian Dick
- Tulane University School of Medicine, Department of Urology, New Orleans, LA, USA
| | - Andrew T Gabrielson
- Tulane University School of Medicine, Department of Urology, New Orleans, LA, USA
| | - Laith M Alzweri
- Tulane University School of Medicine, Department of Urology, New Orleans, LA, USA
| | - Wayne J G Hellstrom
- Tulane University School of Medicine, Department of Urology, New Orleans, LA, USA.
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