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Sleep Medicine Sep 2018Michel Jouvet established a tradition of sleep neurophysiology that inspired several generations of sleep researchers. When I arrived in his laboratory in 1991, it was...
Michel Jouvet established a tradition of sleep neurophysiology that inspired several generations of sleep researchers. When I arrived in his laboratory in 1991, it was known that erection cycles occur during rapid eye movement (REM) sleep in humans. However, it was not known if such erections in sleep occurred in other species, or how REM-related erections were controlled. Employing the classical techniques and systematic approach of Jouvet and his team, I embarked on a journey of discovery. Not only were fundamental principles of REM-related erectile control identified, such as the critical role of the lateral preoptic area in the forebrain, but I also gained a deep appreciation of the scientific approach in the Jouvet tradition. Such insights passed on to his many students, together with a lifetime of friendships and collaborations, have left an indelible mark on our field.
Topics: Animals; Electroencephalography; France; History, 20th Century; History, 21st Century; Humans; Male; Neurophysiology; Penile Erection; Rats; Research; Sleep; Sleep, REM; Wakefulness
PubMed: 30031617
DOI: 10.1016/j.sleep.2018.05.032 -
European Urology Focus Jan 2024Patients with cancer should ideally undergo proactive screening for muscle wasting, dietary deficiencies, functional changes, and/or psychological needs. Alternatively,...
Patients with cancer should ideally undergo proactive screening for muscle wasting, dietary deficiencies, functional changes, and/or psychological needs. Alternatively, a cross-referral strategy may be useful. A multimodal prehabilitation approach can address impairments and optimize function before treatment. Urological prehabilitation has led to improvements in lean body mass, bone density, erectile function, and urinary continence.
Topics: Male; Humans; Preoperative Exercise; Neoplasms; Penile Erection; Combined Modality Therapy; Preoperative Care
PubMed: 38368173
DOI: 10.1016/j.euf.2024.01.013 -
Andrology Nov 2020Males with short penises may suffer from sexual dysfunction and psychological problems. However, currently, managing short penis is a huge challenge.
BACKGROUND
Males with short penises may suffer from sexual dysfunction and psychological problems. However, currently, managing short penis is a huge challenge.
OBJECTIVES
To explore whether inhibition of lysyl oxidase (LOX) activity (anti-LOX) combined with a vacuum device could lengthen the penis of pubertal rat.
MATERIALS AND METHODS
Male rats of different ages were purchased, their exposed penile lengths and weights were measured, and protein expression and lysyl oxidase activity in the corpus cavernosum were analyzed. Fifteen-day-old rats were then purchased and divided into six groups: control, Anti-lysyl oxidase, -200 mm Hg (vacuum device under -200 mm Hg value), -200 mm Hg + Anti-lysyl oxidase, -300 mm Hg, and -300 mm Hg + Anti-lysyl oxidase groups. After the intervention duration of 7 weeks, rats' penile length was measured and erectile function was assessed. The corpus cavernosum was harvested for histopathology and molecular assessments.
RESULTS
Exposed penile length and weight significantly increased with age, especially between 4 and 8 weeks. Both the protein expression and lysyl oxidase activity in corpus cavernosum were the highest at 2 weeks; however, they quickly decreased with age and slowly declined after 8 weeks. Anti-lysyl oxidase significantly increased the penile length by 10.79% over controlled rats, -200 mm Hg + Anti-lysyl oxidase lengthened it by 14.05%, and -300 mm Hg + Anti-lysyl oxidase increased it by 19.84%. Anti-lysyl oxidase significantly reduced lysyl oxidase activity to decrease pyridinoline concentration; however, it did not change desmosine (P = .28), hydroxyproline (P = .14), and total elastin (P = .06) levels. Anti-lysyl oxidase with or without a vacuum device did not diminish erectile function or impair the normal microstructure of corpus cavernosum.
DISCUSSION AND CONCLUSION
The rats' penile growth peaks occurred between 4 and 8 weeks. Anti-lysyl oxidase with a vacuum device promoted penile lengthening by inhibiting pyridinoline production to induce tunica albuginea remodeling. The penile lengthening effect was more obvious in pubertal rats than the adult rats. None of the procedures decreased erectile function.
Topics: Animals; Arterial Pressure; Disease Models, Animal; Erectile Dysfunction; Male; Penile Erection; Penis; Protein-Lysine 6-Oxidase; Rats; Rats, Sprague-Dawley
PubMed: 32578359
DOI: 10.1111/andr.12845 -
Nature Reviews. Urology May 2015The description of the nerve-sparing technique of radical prostatectomy by Walsh was one of the major breakthroughs in the surgical treatment of prostate cancer in the... (Review)
Review
The description of the nerve-sparing technique of radical prostatectomy by Walsh was one of the major breakthroughs in the surgical treatment of prostate cancer in the 20(th) century. However, despite this advance and consequent technological refinements to nerve-sparing surgery, a large proportion of men still suffer from erectile dysfunction (ED) as a complication of prostatectomy. A plethora of therapeutic approaches have been proposed to optimize erectile function recovery in these patients. Several preclinical and translational studies have shown benefits of therapies including PDE5 inhibitor (PDE5I) treatment, immunomodulation, neurotrophic factor administration, and regenerative techniques, such as stem cell therapy, in animal models. However, most of these approaches have either failed to translate to clinical use or have yet to be studied in human subjects. Penile rehabilitation with PDE5Is is currently the most commonly used clinical strategy, in spite of the absence of solid clinical evidence to support its use.
Topics: Anatomic Landmarks; Erectile Dysfunction; Humans; Male; Penile Erection; Penis; Prostatectomy; Prostatic Neoplasms; Recovery of Function
PubMed: 25868558
DOI: 10.1038/nrurol.2015.72 -
Nederlands Tijdschrift Voor Geneeskunde Oct 2023Hasannejadsi et al. presented a predictive model for preserving erectile function after treatments for localized prostate cancer. However, the model has practical...
Hasannejadsi et al. presented a predictive model for preserving erectile function after treatments for localized prostate cancer. However, the model has practical limitations and overestimates the chances of recovery. It focuses on the frequency of erections without considering important factors such as quality and patient satisfaction. The model did not include significant predictors like BMI and smoking. Additionally, it does not account for the extent of nerve sparing during surgery, limiting its usefulness for nerve-sparing prostatectomy patients. This comment emphasizes the importance of penile rehabilitation (PR) after prostate cancer treatment, highlighting the impact of penile inactivity on fibrosis of corporal cavernosal tissue. The author advocate for the implementation of PR during and after prostatecancer treatment and stress the role of healthcare professionals in providing information on rehabilitation options and sexual health in its totallity. The model can serve as a tool to initiate conversations about sexual function but should be complemented with comprehensive care tailored to individual patients.
Topics: Male; Humans; Erectile Dysfunction; Penile Erection; Prostatic Neoplasms; Prostate; Penis; Prostatectomy
PubMed: 37823885
DOI: No ID Found -
Archives of Sexual Behavior Nov 2020Three experiments investigated the influence of penile erection on ascriptions of mental capabilities to men. Drawing on sexual objectification literature and the...
Three experiments investigated the influence of penile erection on ascriptions of mental capabilities to men. Drawing on sexual objectification literature and the distinction between agency and experience in mind perception, three competing predictions were formulated. The mind redistribution hypothesis assumed that penile erection would lower agency and heighten experience attributions, the animalistic dehumanization hypothesis predicted the decrease in agency, but not experience, and the literal objectification hypothesis implied the simultaneous decrease in both agency and experience. In Experiment 1 (N = 219; 128 females), erection salience lowered agency, but not experience capabilities ascribed to male targets. Experiment 2 (N = 201, 113 females) replicated the negative effect of erection salience on perceived agency (but not experience) and revealed that erection salience lowered intentions to hire a male target. This effect was explained with the loss of perceived agency. Experiment 3 (N = 203, 98 females) verified the causal relationship between penile erection, agency and hiring intentions. Taken together, these results supported the animalistic dehumanization hypothesis.
Topics: Adult; Aged; Animals; Humans; Male; Middle Aged; Penile Erection; Sexual Behavior; Social Perception; Young Adult
PubMed: 32895871
DOI: 10.1007/s10508-020-01800-0 -
International Journal of Impotence... Jun 2024The present paper aims to analyze and discuss the available evidence supporting the relationship between male sexual function and elevated prolactin (PRL) levels (HPRL).... (Meta-Analysis)
Meta-Analysis Review
The present paper aims to analyze and discuss the available evidence supporting the relationship between male sexual function and elevated prolactin (PRL) levels (HPRL). Two different sources of data were analyzed. Clinical data were derived from a series of patients seeking medical care for sexual dysfunction at our Unit. Out of 418 studies, 25 papers were used with a meta-analytic approach to evaluate the overall prevalence of HPRL in patients with erectile dysfunction (ED) and to study the influence of HPRL and its treatment on male sexual function. Among 4215 patients (mean age 51.6 ± 13.1 years) consulting for sexual dysfunction at our Unit, 176 (4.2%) showed PRL levels above the normal range. Meta-analytic data showed that HPRL is a rare condition among patients with ED (2 [1;3]%). Either clinical and meta-analytic data confirm a stepwise negative influence of PRL on male sexual desire (S = 0.00004 [0.00003; 0.00006]; I = -0.58915 [-0.78438; -0.39392]; both p < 0.0001 from meta-regression analysis). Normalization of PRL levels is able to improve libido. The role of HPRL in ED remains inconclusive. Data from a meta-analytic approach showed that either HPRL or reduced T levels were independently associated with ED rates. The normalization of PRL levels only partially restored ED. HPRL did not significantly contribute to ED severity, in our clinical setting. In conclusion, treating HPRL can restore normal sexual desire, whereas its effect on erection is limited.
Topics: Humans; Male; Erectile Dysfunction; Hyperprolactinemia; Libido; Prolactin; Middle Aged; Adult; Penile Erection
PubMed: 37340146
DOI: 10.1038/s41443-023-00717-1 -
Sexual Medicine Reviews Jul 2019Rear tip extenders (RTEs) are often used in penile prosthesis surgery, and their value and use have varied with the evolution of penile prostheses. (Review)
Review
INTRODUCTION
Rear tip extenders (RTEs) are often used in penile prosthesis surgery, and their value and use have varied with the evolution of penile prostheses.
AIM
To review the literature addressing RTEs and to introduce a new term, rigidity factor, which quantifies the ratio of inflatable to non-inflatable component of the cylinders.
METHODS
The urologic literature was reviewed for all mention of RTEs. In addition, literature regarding penile prostheses was explored for mention of RTEs.
MAIN OUTCOME MEASURE
A search on PubMed for "rear tip extender" resulted in 17 publications. These publications were reviewed, and references were also explored for related publications.
RESULTS
The history of the development of RTEs, complications associated with the use of RTEs, and current practices in the use of RTEs are all discussed. In addition, recent publications regarding RTEs were examined in detail. RTEs were introduced in the 1980s to improve mechanical survival of prostheses. They were thought to decrease input tubing wear. Although the trend recently has been to place more rear tips, evidence has surfaced suggesting a link to increased need for reoperation with additional RTEs. In addition, we believe that increased length of RTEs can decrease erectile quality. Rigidity factor, defined as the ratio of the live (inflatable) portion of cylinder to the total cylinder length, can be used to quantify the effect of RTE on erectile strength. However, the effects of RTEs on biomechanical properties of the penis when fully inflated are still not fully understood.
CONCLUSION
The use of RTEs is a relatively underexplored area of penile prosthesis placement. Further laboratory and in vivo work will allow for a better understanding of the optimal role of RTEs in penile prosthesis surgery. Thirumavalavan N, Cordon BH, Gross MS, et al. The Rear Tip Extender for Inflatable Penile Prostheses: Introduction of "Rigidity Factor" and Review of the Literature. Sex Med Rev 2019;7:516-520.
Topics: Erectile Dysfunction; Humans; Male; Patient Satisfaction; Penile Erection; Penile Implantation; Penile Prosthesis; Penis; Prosthesis Design
PubMed: 30551977
DOI: 10.1016/j.sxmr.2018.11.001 -
Andrologia Sep 2018It has been assumed that β-endorphin, belonging to the family of opiodergic neuropeptides, might facilitate the inhibition of the male sexual response; however, its...
It has been assumed that β-endorphin, belonging to the family of opiodergic neuropeptides, might facilitate the inhibition of the male sexual response; however, its role in the control of the penile erectile tissue remains to be elucidated. This study aimed to evaluate in healthy men the course of β-endorphin in the systemic and cavernous blood through different stages of sexual arousal. Thirty-four (34) men were exposed to erotic stimuli to induce penile tumescence and rigidity. Blood was aspirated from the corpus cavernosum and a cubital vein during the penile conditions flaccidity, tumescence, rigidity and detumescence. Plasma levels of β-endorphin were determined by means of radioimmunometric methods. The effects of β-endorphin on isolated human penile erectile tissue were investigated in vitro. β-endorphin did not induce a contractile response of the cavernous tissue or reverse the contraction induced by noradrenaline. β-endorphin decreased in the systemic blood when the penis became tumescent and rigid and increased during detumescence. In the cavernous blood, no alterations in β-endorphin concentrations were observed. The drop in β-endorphin observed during tumescence and rigidity seems likely to reflect the inhibition of the opioidergic input with the beginning of sexual arousal.
Topics: Adult; Arousal; Female; Humans; Male; Norepinephrine; Penile Erection; Penis; Sexual Behavior; Transgender Persons; beta-Endorphin
PubMed: 29781087
DOI: 10.1111/and.13049 -
Zhonghua Nan Ke Xue = National Journal... Apr 2019ED is a common male disease, often caused by neurological, vascular or psychological factors, and the diagnostic methods for ED vary widely. The nocturnal penile... (Review)
Review
ED is a common male disease, often caused by neurological, vascular or psychological factors, and the diagnostic methods for ED vary widely. The nocturnal penile tumescence test (NPT) by RigiScan is an objective assessment method used mainly to detect ED and has gained a wide clinical application in recent years. This review focuses on the application value of the six RigiScan parameters in the diagnosis of ED, namely, the number of erections, total erection time, event rigidity of tip/base, event tumescence of tip/base, tumescence activated unit and rigidity activated unit, aiming to provide some help to clinicians and researchers with the application of NPT.
Topics: Erectile Dysfunction; Humans; Male; Penile Erection
PubMed: 32216219
DOI: No ID Found