-
International Journal of Impotence... Jan 2022The golden standard for measuring nocturnal erections is the RigiScan Plus. It is a relatively big and uncomfortable device dating from the previous century. The aim of... (Review)
Review
The golden standard for measuring nocturnal erections is the RigiScan Plus. It is a relatively big and uncomfortable device dating from the previous century. The aim of this perspective is to conceptualize a user-friendly sensor that can be used at home for monitoring nocturnal erections. A literary search is carried out to explore the physiological changes during nocturnal tumescence and detumescence that can be measured non-invasively. Five sensor concepts are considered: plethysmography for penile arterial pulse, displacement sensor for axial length, strain gauges for radial rigidity and circumference, temperature sensors for measuring skin and cavernosal temperature, and a saturation sensor to measure hypoxia in cavernosal tissue during maximal rigidity. We think that due to practical issues, measuring penile length during sleep is impossible. Further research is recommended to investigate the remaining sensor concepts. Whether a combination of these techniques is favorable or only one of them should be studied more thoroughly.
Topics: Erectile Dysfunction; Humans; Male; Penile Erection; Penis; Sleep
PubMed: 33087873
DOI: 10.1038/s41443-020-00365-9 -
Neuromodulation : Journal of the... Dec 2023This study aimed at determining whether stimulation of sacral spinal roots can induce penile erection in cats.
OBJECTIVE
This study aimed at determining whether stimulation of sacral spinal roots can induce penile erection in cats.
MATERIALS AND METHODS
In anesthetized cats, a 20-gauge catheter was inserted into the corpus cavernosum to measure the penile pressure. Stimulus pulses (5-80 Hz, 0.2 ms) were applied through bipolar hook electrodes to sacral ventral roots alone or to combined ventral and dorsal roots of a single S1-S3 segment to induce penile pressure increases and penile erection.
RESULTS
Stimulation of the S1 or S2 ventral root at 30 to 40 Hz induced observable penile erection with rigidity and the largest increase (169 ± 11 cmHO) in penile pressure. Continuous stimulation (10 minutes) of afferent and efferent axons by simultaneous stimulation of the S1 or S2 dorsal and ventral roots at 30 Hz also produced a large increase (190 ± 8 cmHO) in penile pressure that was sustainable during the entire stimulation period. After a complete spinal cord transection at the T9-T10 level, simultaneous stimulation of the S1 or S2 dorsal and ventral roots induced large (186 ± 9 cmHO) and sustainable increases in penile pressure.
CONCLUSION
This study indicates the possibility to develop a novel neuromodulation device to restore penile erection after spinal cord injury using a minimally invasive surgical approach to insert a lead electrode through the sacral foramen to stimulate a sacral spinal root.
Topics: Male; Cats; Animals; Penile Erection; Spinal Nerve Roots; Spinal Cord Injuries; Electric Stimulation
PubMed: 35941016
DOI: 10.1016/j.neurom.2022.06.003 -
Zhonghua Nan Ke Xue = National Journal... Aug 2018Priapism is a rare pathological penile erection, and there are some inadequacies in its definition, classification, diagnosis, and therapeutic strategies. In this...
Priapism is a rare pathological penile erection, and there are some inadequacies in its definition, classification, diagnosis, and therapeutic strategies. In this article, we sum up our years of experience with priapism and put forward some new views and ideas about its definition, classification, pathophysiologic process, pathological change, diagnostic essentials, therapeutic measures, indications of successful treatment, and post-therapeutic rehabilitation of erectile function. We also describe the clinical features, diagnosis and treatment of some special types of priapism, such as intermittent seizure, sleep-related painful erection, and tumor-related priapism, hoping to help urologists and andrologists in the further understanding and management of priapism.
Topics: Humans; Male; Penile Erection; Priapism
PubMed: 30173423
DOI: No ID Found -
Biomolecules Dec 2021Nitric oxide (NO), the neuromodulator/neurotransmitter formed from l-arginine by neuronal, endothelial and inducible NO synthases, is involved in numerous functions... (Review)
Review
Nitric oxide (NO), the neuromodulator/neurotransmitter formed from l-arginine by neuronal, endothelial and inducible NO synthases, is involved in numerous functions across the body, from the control of arterial blood pressure to penile erection, and at central level from energy homeostasis regulation to memory, learning and sexual behavior. The aim of this work is to review earlier studies showing that NO plays a role in erectile function and sexual behavior in the hypothalamus and its paraventricular nucleus and the medial preoptic area, and integrate these findings with those of recent studies on this matter. This revisitation shows that NO influences erectile function and sexual behavior in males and females by acting not only in the paraventricular nucleus and medial preoptic area but also in extrahypothalamic brain areas, often with different mechanisms. Most importantly, since these areas are strictly interconnected with the paraventricular nucleus and medial preoptic area, send to and receive neural projections from the spinal cord, in which sexual communication between brain and genital apparatus takes place, this review reveals that central NO participates in concert with neurotransmitters/neuropeptides to a neural circuit controlling both the consummatory (penile erection, copulation, lordosis) and appetitive components (sexual motivation, arousal, reward) of sexual behavior.
Topics: Animals; Arginine; Central Nervous System; Female; Humans; Male; Nitric Oxide; Nitric Oxide Synthase; Penile Erection; Sexual Behavior
PubMed: 34944510
DOI: 10.3390/biom11121866 -
BJU International Jun 2015
Topics: Humans; Male; Penile Erection; Penis
PubMed: 26018956
DOI: 10.1111/bju.13079 -
Neuropharmacology Sep 2023The cumulative evidence suggests that oxytocin is involved in the male sexual behaviors. However, no significant sexual impairments were observed in oxytocin gene...
The cumulative evidence suggests that oxytocin is involved in the male sexual behaviors. However, no significant sexual impairments were observed in oxytocin gene knock-out (KO) mice, suggesting that oxytocin is not necessary for sexual behavior in male mice. To better understand the role of oxytocin in male erection, two types of oxytocin gene KO mice were created. In the first type, the oxytocin gene was deleted in the zygote, while in the second type, the oxytocin gene was mutated in adulthood by injecting the CRISPR/Cas9 AAVs. The results showed that disrupting the oxytocin gene at either the embryonic or adult stage did not affect erection, indicating that oxytocin is not necessary for penile erection. Pharmacologically, injecting oxytocin receptor agonist Carbetocin into the VTA of the oxytocin gene KO mice still evoked penile erection. By employing the Oxt-Ires-Cre mice, we found that specifically activating oxytocinergic neurons through chemogenetics strongly induced penile erection, while inhibiting these neurons blocked the erection responses. Furthermore, ablating PVN oxytocinergic neurons abolished the male erection response. In conclusion, although the neuropeptide oxytocin is not essential for male erection, the activity of oxytocinergic neurons is required. Our results might reflect the redundancy in the central nerve system in the sense that many signals contribute to the activation of oxytocinergic neurons to evoke penile erection during sexual behaviors.
Topics: Animals; Male; Mice; Neurons; Paraventricular Hypothalamic Nucleus; Penile Erection; Receptors, Oxytocin; Oxytocin
PubMed: 37164226
DOI: 10.1016/j.neuropharm.2023.109576 -
Urologic Oncology Sep 2022With an increase in the number of cancer survivors each year, male sexual dysfunction becomes an important topic for discussion between patients and providers who treat... (Review)
Review
BACKGROUND
With an increase in the number of cancer survivors each year, male sexual dysfunction becomes an important topic for discussion between patients and providers who treat cancer. The aim of this article is to review types and mechanisms of sexual dysfunction after cancer therapy and discuss treatment options.
METHODS
Contemporary concepts regarding male sexual dysfunction after cancer treatment are reviewed and translated for clinical utility.
FINDINGS
To optimize recovery of erectile capacity after erectile dysfunction causing cancer treatments, a penile rehabilitation protocol involving phosphodiesterase inhibitors, vacuum erection device, intra corporal injections, or a combination is likely to provide some degree of clinically significant benefit. Treating hypogonadism post cancer treatment depends on the type of cancer that has been treated and patient comorbidities. Anejaculation after cancer treatments is typically not successfully or reliably treated due to the mechanism and severity of sympathetic nerve injury. Semen cryopreservation prior to cancer treatments that may injure nerve fibers essential for the ejaculatory response is highly recommended.
CONCLUSION
Management of post cancer treatment sexual dysfunction requires identification of this problem and referral to a specialist if necessary. There are several management options available that can greatly enhance quality of life in this often overlooked aspect of post cancer treatment care.
Topics: Erectile Dysfunction; Humans; Male; Neoplasms; Penile Erection; Prostatectomy; Quality of Life
PubMed: 32859462
DOI: 10.1016/j.urolonc.2020.08.006 -
Andrologia Jun 2021Previous studies have shown that elevated levels of high-density lipoprotein (HDL) could inhibit penile erection, but the relationship between HDL and the erection of...
Previous studies have shown that elevated levels of high-density lipoprotein (HDL) could inhibit penile erection, but the relationship between HDL and the erection of the penile tip or base has not been extensively researched. We investigated the effects of HDL on erection of the penile tip and base through a cross-sectional study of 113 patients with erectile dysfunction, using a cut-off score of ≤21 on the International Index of Erectile Function-5. The following patient data were collected: nocturnal penile tumescence; blood pressure; platelet count; platelet distribution width; mean platelet volume; plateletcrit; and levels of serum glucose, total cholesterol, triglyceride, HDL, and low-density lipoprotein. Univariate and multivariate analyses were used to assess the association between HDL levels and the erection of the penile tip and base. We confirmed that HDL had a beneficial effect on penile erectile function. We also found that when the HDL level exceeded the normal range, the change in HDL had a significant effect on the penile base. In addition, our study did not find any relationship between platelet parameters and erection of the penile tip or penile base.
Topics: Cross-Sectional Studies; Erectile Dysfunction; Humans; Lipoproteins, HDL; Male; Penile Erection; Penis
PubMed: 33774838
DOI: 10.1111/and.13979 -
The Journal of Urology Jul 2022Priapism is a persistent penile erection that continues hours beyond, or is unrelated to, sexual stimulation and results in a prolonged and uncontrolled erection. Given...
PURPOSE
Priapism is a persistent penile erection that continues hours beyond, or is unrelated to, sexual stimulation and results in a prolonged and uncontrolled erection. Given its time-dependent and progressive nature, priapism is a situation that both urologists and emergency medicine practitioners must be familiar with and comfortable managing.
METHODOLOGY
A comprehensive search of the literature on acute ischemic priapism and non-ischemic priapism (NIP) was performed by Emergency Care Research Institute for articles published between January 1, 1960 and May 1, 2020. A search of the literature on NIP, recurrent priapism, prolonged erection following intracavernosal vasoactive medication, and priapism in patients with sickle cell disease was conducted by Pacific Northwest Evidence-based Practice Center for articles published between 1946 and February 19, 2021. Searches identified 4117 potentially relevant articles, and 3437 of these were excluded at the title or abstract level for not meeting inclusion criteria. Full texts for the remaining 680 articles were ordered, and ultimately 203 unique articles were included in the report.
RESULTS
This Guideline provides a clinical framework for the treatment (non-surgical and surgical) of NIP, recurrent ischemic priapism, and priapism in patients with sickle cell disease. The treatment of patients with a prolonged erection following intracavernosal vasoactive medication is also included. The AUA guideline on the diagnosis of priapism and the treatment of acute ischemic priapism was published in 2021.
CONCLUSIONS
All patients with priapism should be evaluated emergently to identify the sub-type of priapism (acute ischemic versus non-ischemic) and those with an acute ischemic event should be provided early intervention when indicated. NIP is not an emergency and treatment must be based on patient objectives, available resources, and clinician experience. Management of recurrent ischemic priapism requires treatment of acute episodes and a focus on future prevention of an acute ischemic event. Sickle cell disease patients presenting with an acute ischemic priapism event should initially be managed with a focus on urologic relief of the erection; standard sickle cell assessment and interventions should be considered concurrent with urologic intervention. Treatment protocols for a prolonged, iatrogenic erection must be differentiated from protocols for true priapism.
Topics: Anemia, Sickle Cell; Humans; Ischemia; Male; Penile Erection; Penis; Priapism
PubMed: 35536142
DOI: 10.1097/JU.0000000000002767 -
The Journal of Sexual Medicine Jan 2017The biological importance of nanotechnology-based delivery vehicles for in vivo tissue regeneration is gaining acceptance by the medical community; however, its... (Review)
Review
INTRODUCTION
The biological importance of nanotechnology-based delivery vehicles for in vivo tissue regeneration is gaining acceptance by the medical community; however, its relevance and incorporation into the treatment of sexual dysfunction are evolving and have not been well evaluated.
AIM
To provide scientific evidence examining the use of state-of-the-art nanotechnology-based delivery methodology in the treatment of erectile dysfunction (ED) in animal models and in patients.
METHODS
This review assessed the current basic science literature examining the role of nanotechnology-based delivery vehicles in the development of potential ED therapies.
RESULTS
There are four primary areas where nanotechnology has been applied for ED treatment: (i) topical delivery of drugs for on-demand erectile function, (ii) injectable gels into the penis to prevent morphologic changes after prostatectomy, (iii) hydrogels to promote cavernous nerve regeneration or neuroprotection, and (iv) encapsulation of drugs to increase erectile function (primarily of phosphodiesterase type 5 inhibitors).
CONCLUSION
Basic science studies provide evidence for a significant and evolving role for nanotechnology in the development of therapies for ED and suggest that properly administered nano-based therapies might be advantageous for treating male sexual dysfunction.
Topics: Animals; Disease Models, Animal; Erectile Dysfunction; Humans; Male; Nanotechnology; Nerve Regeneration; Penile Erection; Phosphodiesterase 5 Inhibitors; Prostatectomy
PubMed: 28065359
DOI: 10.1016/j.jsxm.2016.11.318