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International Journal of Molecular... Feb 2023Severe vascular and nerve damage from diabetes is a leading cause of erectile dysfunction (ED) and poor response to oral phosphodiesterase 5 inhibitors. Argonaute 2...
Severe vascular and nerve damage from diabetes is a leading cause of erectile dysfunction (ED) and poor response to oral phosphodiesterase 5 inhibitors. Argonaute 2 (Ago2), a catalytic engine in mammalian RNA interference, is involved in neurovascular regeneration under inflammatory conditions. In the present study, we report that Ago2 administration can effectively improve penile erection by enhancing cavernous endothelial cell angiogenesis and survival under diabetic conditions. We found that although Ago2 is highly expressed around blood vessels and nerves, it is significantly reduced in the penis tissue of diabetic mice. Exogenous administration of the Ago2 protein restored erectile function in diabetic mice by reducing reactive oxygen species production-signaling pathways (inducing eNOS Ser/NF-κB Ser signaling) and improving cavernous endothelial angiogenesis, migration, and cell survival. Our study provides new evidence that Ago2 mediation may be a promising therapeutic strategy and a new approach for diabetic ED treatment.
Topics: Animals; Humans; Male; Mice; Diabetes Mellitus, Experimental; Diabetes Mellitus, Type 1; Erectile Dysfunction; Mammals; Nitric Oxide Synthase Type III; Penile Erection; Penis; Reactive Oxygen Species; Streptozocin
PubMed: 36769259
DOI: 10.3390/ijms24032935 -
Fertility and Sterility Feb 2017As paternal age increases in the developed world, more attention has been given to the effects of age on male reproductive and sexual function. Although the biologic... (Review)
Review
As paternal age increases in the developed world, more attention has been given to the effects of age on male reproductive and sexual function. Although the biologic potential for reproductive continues for most of a man's life, changes in sperm production do occur. In addition, erectile function changes with age, caused by the same factors that lead to other vascular disease.
Topics: Age Factors; Erectile Dysfunction; Fertility; Humans; Infertility, Male; Male; Paternal Age; Penile Erection; Reproductive Health; Risk Factors; Sexual Behavior; Spermatogenesis; Spermatozoa
PubMed: 28160919
DOI: 10.1016/j.fertnstert.2016.12.018 -
Andrology Sep 2020The aim of the study was to investigate the ability of the blood lipid parameters to predict the discrimination of arteriogenic erectile dysfunction (ED).
OBJECTIVES
The aim of the study was to investigate the ability of the blood lipid parameters to predict the discrimination of arteriogenic erectile dysfunction (ED).
MATERIALS AND METHODS
260 subjects with ED and 60 healthy controls were enrolled. Eight lipid parameters, including total cholesterol (TC), triglycerides (TG), LDL-C, HDL-C, non-HDL-C, TC/HDL ratio, TG/HDL ratio, and LDL/HDL ratio, together with other plasma biomarkers like sex hormones were measured in all participants. Nocturnal penile tumescence (NPT), penile color Doppler ultrasonography (pDUS), and neurophysiological tests were conducted in the ED group.
RESULTS
Forty-four ED patients with normal NPT, and 84 with normal vasculature or mixed vascular abnormalities were excluded. The remaining 132 men were classified into two groups, arteriogenic ED (n = 87) and venous leakage (n = 45), by pDUS. TC/HDL, LDL/HDL, and LDL-C were significantly higher (P < .05) and HDL-C was significantly lower (P < .05) in the arteriogenic ED group when compared with the venous and the control groups. Receiver operating characteristic curve analysis identified area under the curve values that were predictive of arteriogenic ED for: TC/HDL and LDL/HDL 0.720 and 0.737, TC/HDL ≥ 3.73 and LDL/HDL ≥ 2.01 (sensitivity: 56.3%; specificity: 83.3% vs sensitivity: 55.2%; specificity: 91.7%), HDL-C (0.791), ≤1.25 mmol/L (sensitivity: 69%; specificity: 81.7%), LDL-C (0.641), ≥2.41 mmol/L (sensitivity: 55.2%; specificity: 76.7%).In the arteriogenic ED group, a significant inverse correlation was detected between TC/HDL, LDL/HDL, LDL-C and 10-minutes peak systolic velocity (PSV) (All P < .01)and a significant positive correlation was recognized between HDL-C and 10-minutes PSV(P < .01). Multivariate step wise linear regression indicated lipid parameters of LDL/HDL and HDL-C were significantly associated with 10-MinPSV (P < .01).
CONCLUSION
These findings suggest the LDL/HDL and HDL-C might be a powerful indicator to predict and diagnose arteriogenic ED, and lipid-lowing therapy should be considered for these patients.
Topics: Adult; Biomarkers; Humans; Impotence, Vasculogenic; Lipids; Male; Penile Erection; Predictive Value of Tests; Prospective Studies; Ultrasonography, Doppler, Color
PubMed: 32087037
DOI: 10.1111/andr.12776 -
Andrology May 2022Hyperhomocysteinemia may contribute to the development of endothelial dysfunction and, consequently, atherosclerosis, a systemic disease involving the vessels that may...
INTRODUCTION
Hyperhomocysteinemia may contribute to the development of endothelial dysfunction and, consequently, atherosclerosis, a systemic disease involving the vessels that may affect the cavernous arteries leading to vasculogenic erectile dysfunction. Our study aims therefore to explore the relationship between homocysteine levels and velocimetric parameters detected by basal penile duplex ultrasound such as peak systolic velocity and flaccid penile acceleration in patients with erectile dysfunction.
METHODS
A cross-sectional study was conducted collecting clinical, metabolic, hormonal, and instrumental (basal penile duplex ultrasound) data in patients affected by vasculogenic erectile dysfunction.
RESULTS
Data of 126 subjects affected by erectile dysfunction were collected. Mean age was 52.1 ± 12.6 years, whereas mean body mass index was 25.6 ± 4.0 kg/m . Basal penile duplex ultrasound showed peak systolic velocity values of 13.1 ± 2.9 cm/s and mean flaccid penile acceleration of 2.28 ± 0.70 m/s , with a strong correlation among these two parameters (r = 0.690; p < 0.001). Frankly pathological values of peak systolic velocity and flaccid penile acceleration were detected in 39.7% and 4.8% of the subjects examined, respectively. Mean homocysteine levels were 14.9 ± 9.5 μmol/l. Homocysteine values >15 μmol/l were found in 26% of the subjects with erectile dysfunction. Peak systolic velocity values and homocysteine levels showed an inverse correlation (r = -0.213; p = 0.03). Similarly, flaccid penile acceleration values were inversely correlated to homocysteine levels (r = -0.199; p = 0.05). In addition, an inverse correlation was found between both peak systolic velocity and flaccid penile acceleration and body mass index, atherogenic lipid pattern, and age. Homocysteine and metabolic parameters showed no significant correlations.
CONCLUSION
Hyperhomocysteinemia is highly prevalent in erectile dysfunction patients. The results of our study show that homocysteine levels correlate with velocimetric parameters assessed by basal penile duplex ultrasound, confirming the role of hyperhomocysteinemia in the genesis of erectile dysfunction of arterial origin.
Topics: Adult; Cross-Sectional Studies; Erectile Dysfunction; Homocysteine; Humans; Hyperhomocysteinemia; Male; Middle Aged; Penile Erection; Penis
PubMed: 35224883
DOI: 10.1111/andr.13169 -
European Review For Medical and... Apr 2023Erectile dysfunction (ED) refers to an inability to achieve or maintain a firm penile erection sufficient for satisfactory sexual intercourse. Insufficient, irregular...
OBJECTIVE
Erectile dysfunction (ED) refers to an inability to achieve or maintain a firm penile erection sufficient for satisfactory sexual intercourse. Insufficient, irregular sleep and sleep disorders adversely affect human health, including sexual function. Significant differences between biological rhythms (chronotypes) have been reported. In the present study we examine the effect of sleep quality and chronotype differences on ED patients and a control group.
PATIENTS AND METHODS
The study included 69 patients who presented with ED and 64 healthy controls. The respondents completed a sociodemographic data form, and disease severity in the ED group was measured using the International Index of Erectile Function (IIEF). The participants were further administered the Hospital Anxiety and Depression Scale (HADS), Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI) and Morningness-Eveningness Questionnaire (MEQ), and the scale scores were compared statistically between the patient and control groups.
RESULTS
There was no difference in the age, body mass index (BMI), alcohol use and smoking of the ED and healthy control groups, while the IIEF score was significantly lower in the ED group than in the control group. The PSQI subscale scores other than for sleep duration subscale, the PSQI global score and the HADS score were higher in the ED group than in the control group, while there was no difference between the groups in the MEQ and ISI scores. The IIEF score was correlated with the PSQI and HADS scores, and the PSQI score with the ISI and HADS scores.
CONCLUSIONS
It would be useful to evaluate sleep quality in addition to anxiety and depression while evaluating patients with ED. Our study found no relationship between chronotype differences and ED.
Topics: Male; Humans; Erectile Dysfunction; Sleep Quality; Chronotype; Penile Erection; Smoking; Surveys and Questionnaires; Sleep
PubMed: 37070877
DOI: 10.26355/eurrev_202304_31907 -
Andrology Mar 2015Although there are several methods for assessing erectile function in rats, the standard methods for telemetric monitoring have not been established. Theoretically... (Comparative Study)
Comparative Study
Although there are several methods for assessing erectile function in rats, the standard methods for telemetric monitoring have not been established. Theoretically assessment of spontaneous erection (SE) seems to be a physiologic method but it needs long measuring time and additional efforts. Apomorphine-induced erection (AIE) is one available and simple method; however, the correlation with SE has not been assessed. We compared erection profiles of AIE and SE in normal and two disease rat models using telemetric assessment of intracavernosal pressure (ICP). Seven-week-old male Sprague-Dawley rats were assigned to normal control, diabetes mellitus (DM) and hypercholesterolemia (HC) group. After 19 weeks a telemetric pressure sensor (C40; Data Sciences) was surgically implanted in the corpus cavernosum. One week later, ICP was recorded in freely moving rats after intraperitoneal apomorphine (100 μg/kg) injection (AIE) or during SE. Sexual events were visually identified and recorded. Only the pressure increases that occurred during sexual behavior were analyzed. We compared the erectile profiles such as duration, maximal ICP and the area under the curve (AUC, area under time × ICP curves). Two-way anova revealed no significant effect of the measuring methods on the mean AUC (F1,43 = 2.756, p-value = 0.104), but a significant effect of different disease models on mean AUC (two-way anova: F2,43 = 12.929, p-value < 0.001) was observed. The mean AUC of normal control rats was significantly higher than that of DM and HC rats (Bonferroni post hoc test: p < 0.001 and p = 0.001, respectively). ICP measurements using a telemetric device showed no significant difference in AUC between AIE and SE. AIE is easy and requires less time than SE measurements. Therefore, AIE could be a useful method to evaluate ICP in rats.
Topics: Animals; Apomorphine; Male; Penile Erection; Rats; Rats, Sprague-Dawley; Telemetry
PubMed: 25656097
DOI: 10.1111/andr.12004 -
International Braz J Urol : Official... 2021
Topics: Erectile Dysfunction; Humans; Male; Penile Erection; Penile Neoplasms; Penis
PubMed: 33620996
DOI: 10.1590/S1677-5538.IBJU.2019.0119.1 -
Life Sciences Nov 2021Androgen deprivation therapy is a common prostate cancer treatment which causes men to have castrate levels of testosterone. Unfortunately, most testosterone deficient...
AIMS
Androgen deprivation therapy is a common prostate cancer treatment which causes men to have castrate levels of testosterone. Unfortunately, most testosterone deficient patients will suffer severe erectile dysfunction (ED) and have no effective ED treatment options. Testosterone deficiency causes endothelial dysfunction and impairs penile vasodilation necessary to maintain an erection. Recent evidence demonstrates testosterone activates androgen receptors (AR) and generates nitric oxide (NO) through the Akt-endothelial NO synthase (eNOS) pathway; however, it remains unknown how castration impacts this signaling pathway.
MATERIALS AND METHODS
In this study, we used a surgically castrated rat model to determine how castration impacts ex vivo internal pudendal artery (IPA) and penile relaxation through the Akt-eNOS pathway.
KEY FINDINGS
Unlike systemic vasculature, castration causes significant IPA and penis endothelial dysfunction associated with a 50% AR reduction. Though testosterone and acetylcholine (ACh) both phosphorylate Akt and eNOS, castration did not affect testosterone-mediated IPA and penile Akt or eNOS phosphorylation. Surprisingly, castration increases ACh-mediated Akt and eNOS phosphorylation but reduces the eNOS dimer to monomer ratio. Akt inhibition using 10DEBC preserves IPA eNOS dimers. Functionally, 10DEBC reverses castration induced ex vivo IPA and penile endothelial dysfunction.
SIGNIFICANCE
These data demonstrate how castration uncouples eNOS and provide a novel strategy for improving endothelial-dependent relaxation necessary for an erection. Further studies are needed to determine if Akt inhibition may treat or even prevent ED in testosterone deficient prostate cancer survivors.
Topics: Animals; Castration; Endothelium, Vascular; Iliac Artery; Male; Models, Animal; Nitric Oxide Synthase Type III; Penile Erection; Penis; Proto-Oncogene Proteins c-akt; Rats; Rats, Sprague-Dawley; Testosterone; Vasodilation
PubMed: 34543641
DOI: 10.1016/j.lfs.2021.119966 -
The Journal of Sexual Medicine Jun 2019Erectile dysfunction supplements (ED-Ss) are featured on online marketplaces like Amazon.com, with dedicated pages and claims that they naturally treat ED. However,...
INTRODUCTION
Erectile dysfunction supplements (ED-Ss) are featured on online marketplaces like Amazon.com, with dedicated pages and claims that they naturally treat ED. However, their efficacy and safety are largely unknown, limiting the ability to counsel patients regarding their use.
AIM
To evaluate the highest rated and most frequently reviewed ED-Ss on Amazon.com to facilitate patient counseling regarding marketing myths, ingredient profiles, and evidence for product efficacy and safety.
METHODS
The Amazon marketplace was queried using the key term "erectile dysfunction" with default search settings and ranking items based on relevance. The top 6 ED-S products identified on September 29, 2018, were reviewed based on price, ratings, reviews, manufacturer, and ingredients. Consumer reviews were categorized using subtopics within the International Index of Erectile Function (IIEF) questionnaire to better understand ED-S efficacy and then reanalyzed following filtration of untrustworthy comments using ReviewMeta.com, a proprietary Amazon review analysis software.
OUTCOMES
Quantitative and qualitative evaluation of ED-S products sold on Amazon.com.
RESULTS
The top 6 ED-Ss had an average of 2,121 ± 1,282 reviews and a mean rating of 3.92 ± 0.42 stars. A total of 21 ingredients were identified in these ED-Ss. Ginseng, horny goat weed, L-arginine, and tongkat ali were the most popular ingredients included in the analyzed products. Our literature review identified 413 studies involving the 21 identified ingredients, of which 59 (16%) involved human subjects. Among these 69 human studies, only 12 (17%) investigated supplement ingredients individually and reported improvement in ED. Analysis of top-ranked customer reviews from the first 2 pages of reviews for each supplement revealed differences in IIEF scores before and after ReviewMeta.com filtration. After filtration, we observed a 77% decrease in reviews reporting improved erection strength, an 83% decrease in reviews reporting improved ability to maintain erection, a 90% decrease in reviews reporting increased sexual satisfaction, an 88% decrease in reviews reporting increased enjoyment with intercourse, and an 89% decrease in reviews reporting increased erection confidence.
STRENGTHS & LIMITATIONS
Study strengths include a novel approach to ascertaining consumers' perceptions and satisfaction with ED-Ss and practical summary information that clinicians can provide to patients. Limitations include selection bias, the small number of supplements analyzed, and the proprietary nature of the Amazon review analysis software.
CONCLUSIONS
Our investigation revealed that human studies evaluating the efficacy of ED-S ingredients are limited and have yielded no definitive findings of the effects on ED. Patients considering ED-S use should receive appropriate counseling, given the prevalence of disingenuous reviews and the ready availability of Food and Drug Administration-approved drug therapies. Balasubramanian A, Thirumavalavan N, Srivatsav A, et al. An Analysis of Popular Online Erectile Dysfunction Supplements. J Sex Med 2019;16:843-852.
Topics: Adult; Aged; Arginine; Coitus; Dietary Supplements; Erectile Dysfunction; Fatty Acids; Humans; Internet; Male; Middle Aged; Orgasm; Panax; Penile Erection; Plant Extracts; Treatment Outcome
PubMed: 31036522
DOI: 10.1016/j.jsxm.2019.03.269 -
Asian Journal of Andrology 2017Most widespread three-component penile prosthesis models are 700CX™ and Titan ® . Our purpose is to assess patient and partner satisfaction after the first implant.... (Comparative Study)
Comparative Study
Most widespread three-component penile prosthesis models are 700CX™ and Titan ® . Our purpose is to assess patient and partner satisfaction after the first implant. This is a multicenter, retrospective, nonrandomized study in which all patients who met the inclusion criteria between 2009 and 2013 were included. In total, 248 patients agreed to participate. To evaluate patient satisfaction, a validated but modified 11-question questionnaire was completed (EDITS); and a nonvalidated two-item questionnaire was given to the partner. Statistical analysis used an ordinal logistic regression model. Two hundred and forty-eight patients (194 with 700CX™ vs 54 with Titan®) and 207 couples completed the questionnaire (165 with 700CX™ vs 42 with Titan®). Overall satisfaction was high. Both showed great reliability for sexual intercourse and high compliance with prior expectations. Most patients were able to manage the penile prosthesis correctly within 6 months. Postoperative penile shortening led to some dissatisfaction in 42% and 46% of cases (700CX™ /Titan®). Significant differences were found in three questions of patients' questionnaire. There were more patients satisfied with the 700CX™ (P = 0.0001). No patient with Titan® implant took longer than 6 months to optimal management. Only 4% of patients with 700CX™ implant were dissatisfied with the deflation, in contrast to 24% with the Titan® (P = 0.0031). Of the two partners' questions, one showed a statistically significant difference (P = 0.0026). It seems that group 700CX™ would recommend to re-implant the prosthesis with a greater tendency. The overall satisfaction was very high for both prostheses. The final aspect of the erected and flaccid penis was satisfactory, but both groups showed significant discontent with its final size. Partners' overall satisfaction was high.
Topics: Coitus; Female; Humans; Male; Middle Aged; Patient Satisfaction; Penile Erection; Penile Implantation; Penile Prosthesis; Penis; Prosthesis Design; Retrospective Studies; Sexual Partners; Surveys and Questionnaires; Treatment Outcome
PubMed: 26806085
DOI: 10.4103/1008-682X.172822