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Frontiers in Endocrinology 2023Erectile dysfunction is a common disease of the male reproductive system, which seriously affects the life quality of patients and their partners. At present, erectile... (Review)
Review
Erectile dysfunction is a common disease of the male reproductive system, which seriously affects the life quality of patients and their partners. At present, erectile dysfunction is considered as a social-psychological-physiological disease with complex etiology and various treatment methods. Oral PDE5I is the first-line treatment for erectile dysfunction with the advantages of high safety, good effect and non-invasiveness. But intracavernosal injection, hormonal replacement therapy, vacuum erection device, penile prosthesis implantation can also be alternative treatments for patients have organic erectile dysfunction or tolerance to PDE5I. With the rapid development of technologies, some new methods, such as low-intensity extracorporeal shock wave and stem cell injection therapy can even repair the organic damage of the corpora cavernosa. These are important directions for the treatment of male erectile dysfunction in the future. In this mini-review, we will introduce these therapies in detail.
Topics: Male; Humans; Erectile Dysfunction; Phosphodiesterase 5 Inhibitors; Treatment Outcome
PubMed: 36923224
DOI: 10.3389/fendo.2023.1148834 -
Brain Sciences May 2023Erectile dysfunction (ED) is the inability to get and maintain an adequate penile erection for satisfactory sexual intercourse. Due to its negative impacts on men's life... (Review)
Review
Erectile dysfunction (ED) is the inability to get and maintain an adequate penile erection for satisfactory sexual intercourse. Due to its negative impacts on men's life quality and increase during aging (40% of men between 40 and 70 years), ED has always attracted researchers of different disciplines, from urology, andrology and neuropharmacology to regenerative medicine, and vascular and prosthesis implant surgery. Locally and/or centrally acting drugs are used to treat ED, e.g., phosphodiesterase 5 inhibitors (first in the list) given orally, and phentolamine, prostaglandin E1 and papaverine injected intracavernously. Preclinical data also show that dopamine D receptor agonists, oxytocin and α-MSH analogues may have a role in ED treatment. However, since pro-erectile drugs are given on demand and are not always efficacious, new strategies are being tested for long lasting cures of ED. These include regenerative therapies, e.g., stem cells, plasma-enriched platelets and extracorporeal shock wave treatments to cure damaged erectile tissues. Although fascinating, these therapies are laborious, expensive and not easily reproducible. This leaves old vacuum erection devices and penile prostheses as the only way to get an artificial erection and sexual intercourse with intractable ED, with penile prosthesis used only by accurately selected patients.
PubMed: 37239274
DOI: 10.3390/brainsci13050802 -
Nature Communications Jul 2022The corpus cavernosum is the most important structure for penile erection, and its dysfunction causes many physiological and psychological problems. However, its...
The corpus cavernosum is the most important structure for penile erection, and its dysfunction causes many physiological and psychological problems. However, its cellular heterogeneity and signalling networks at the molecular level are poorly understood because of limited access to samples. Here, we profile 64,993 human cavernosal single-cell transcriptomes from three males with normal erection and five organic erectile dysfunction patients. Cell communication analysis reveals that cavernosal fibroblasts are central to the paracrine signalling network and regulate microenvironmental homeostasis. Combining with immunohistochemical staining, we reveal the cellular heterogeneity and describe a detailed spatial distribution map for each fibroblast, smooth muscle and endothelial subcluster in the corpus cavernosum. Furthermore, comparative analysis and related functional experiments identify candidate regulatory signalling pathways in the pathological process. Our study provides an insight into the human corpus cavernosum microenvironment and a reference for potential erectile dysfunction therapies.
Topics: Erectile Dysfunction; Humans; Male; Muscle, Smooth; Penile Erection; Penis; Transcriptome
PubMed: 35879305
DOI: 10.1038/s41467-022-31950-9 -
Translational Andrology and Urology May 2023We investigated the relationship between the size of the penis and that of the nose.
BACKGROUND
We investigated the relationship between the size of the penis and that of the nose.
METHODS
We retrospectively analyzed 1,160 patients whose nose and penis sizes were measured. These participants were selected from a subset of 1,531 patients who visited the Dr. JOMULJU Urology Clinic between March and October 2022. Patients aged <20 years and those who underwent surgery for the nose and penis were excluded. Nose size was determined by measuring the length, width, and height of the nose, which were used to calculate the volume of the triangular pyramid. Stretched penile length (SPL) and penile circumference before erection were measured. The participants' height, weight, foot size, and serum testosterone levels were measured. Testicular size was measured using ultrasonography. Predictors of penile length and circumference were assessed using linear regression analysis.
RESULTS
The participants' average age was 35.5 years, mean SPL was 11.2 cm, and mean penile circumference was 6.8 cm. Univariate analysis revealed that body weight, body mass index (BMI), the serum testosterone level, and nose size were associated with SPL. Multivariable analysis revealed that BMI (P=0.001) and nose size (P=0.023) were significant predictors of SPL. Univariate analysis revealed that penile circumference was related to an individual's height, weight, BMI, nose size, and foot size. Multivariable analysis revealed that body weight (P=0.008) and testicular size (P=0.002) were significant predictors of penile circumference.
CONCLUSIONS
Nose size was a significant predictor of penile size. The sizes of the penis and nose increased with a decrease in BMI. This interesting study confirms the truth of an erstwhile myth about penis size.
PubMed: 37305632
DOI: 10.21037/tau-22-869 -
Andrologia Jul 2021The aim of the present study was to evaluate the size of the penis in flaccidity and in erection of Italian men. A total of 4,685 men living in Italy and who have been...
The aim of the present study was to evaluate the size of the penis in flaccidity and in erection of Italian men. A total of 4,685 men living in Italy and who have been visited at the Italian urology operating units were involved in the study between January 2019 and January 2020. Each patient was given details on how to measure their penis (erect length and circumference) in flaccidity and in erection, from the lower base to the distal penile tip. Mean (standard deviation [SD]) flaccid penis length was 9.47 (2.69), mean (SD) flaccid penis circumference was 9.59 (3.08), mean (SD) erect penis length was 16.78 (2.55) and mean (SD) erect penis circumference was 12.03 (3.82). At the linear regression analysis, height was associated with flaccid penis length (β = 0.04; p-value = .01), and erect penis length was (β = 0.05; p-value < .01) and erect penis circumference was (β = 0.06; p-value < .01). Height is proportional to the length of the penis in flaccidity and in erection, and to the circumference in erection. The increase in BMI leads to a reduction in the length of the erect penis, as well as weight gain reduces the length of the flaccid penis.
Topics: Humans; Italy; Male; Penile Erection; Penis; Regression Analysis
PubMed: 33748967
DOI: 10.1111/and.14053 -
Nature Communications Jun 2023Phosphodiesterase type 5 inhibitors (PDE5is) constitute the primary therapeutic option for treating erectile dysfunction (ED). Nevertheless, a substantial proportion of...
Phosphodiesterase type 5 inhibitors (PDE5is) constitute the primary therapeutic option for treating erectile dysfunction (ED). Nevertheless, a substantial proportion of patients, approximately 30%, do not respond to PDE5i treatment. Therefore, new treatment methods are needed. In this study, we identified a pathway that contributes to male erectile function. We show that mechano-regulated YAP/TAZ signaling in smooth muscle cells (SMCs) upregulates adrenomedullin transcription, which relaxed the SMCs to maintain erection. Using single-nucleus RNA sequencing, we investigated how penile erection stretches the SMCs, inducing YAP/TAZ activity. Subsequently, we demonstrate that YAP/TAZ plays a role in erectile function and penile rehabilitation, using genetic lesions and various animal models. This mechanism relies on direct transcriptional regulation of adrenomedullin by YAP/TAZ, which in turn modulates penile smooth muscle contraction. Importantly, conventional PDE5i, which targets NO-cGMP signaling, does not promote erectile function in YAP/TAZ-deficient ED model mice. In contrast, by activating the YAP/TAZ-adrenomedullin cascade, mechanostimulation improves erectile function in PDE5i nonrespondent ED model rats and mice. Furthermore, using clinical retrospective observational data, we found that mechanostimulation significantly promotes erectile function in patients irrespective of PDE5i use. Our studies lay the groundwork for exploring the mechano-YAP/TAZ-adrenomedullin axis as a potential target in the treatment of ED.
Topics: Animals; Humans; Male; Mice; Rats; Adrenomedullin; Erectile Dysfunction; Penile Erection; Penis; Retrospective Studies; YAP-Signaling Proteins; Transcriptional Coactivator with PDZ-Binding Motif Proteins
PubMed: 37353497
DOI: 10.1038/s41467-023-39009-z -
Urology Case Reports Jul 2022Penile neoplasm is uncommon, and multiple penile schwannomas are even rarer. We report a case of a 37-year-old man with multiple schwannomas on the left side of the...
Penile neoplasm is uncommon, and multiple penile schwannomas are even rarer. We report a case of a 37-year-old man with multiple schwannomas on the left side of the penis, which had been present for more than 10 years without significant enlargement during erection and had recently been associated with mild pain. Ultrasonography revealed several subcutaneous heterogeneous hypoechoic of penile, the larger of which was approximately 1.9 × 0.9 cm. The patient underwent penile mass excision, and pathology and immunohistochemistry confirmed that it was schwannoma. The patient was followed up for 3 years without recurrence or metastasis.
PubMed: 35586399
DOI: 10.1016/j.eucr.2022.102107