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F1000Research 2022Priapism induces regulation of Transforming Growth Factor-β1 (TGF-β1) expression and collagen-type-1 deposition. This will replace the normal corpora cavernosa with...
BACKGROUND
Priapism induces regulation of Transforming Growth Factor-β1 (TGF-β1) expression and collagen-type-1 deposition. This will replace the normal corpora cavernosa with fibrotic tissue which eventually resulted in erectile dysfunction. It is also known that the fibrosis process of corpora cavernosa is related to Renin-Angiotensin II System (RAS). Angiotensin II receptor blockers (ARB), especially losartan, inhibit the inflammation process and fibrotic tissue formation. This study evaluated the effect of losartan in reducing fibrosis in priapism by evaluating TGF-β1 and collagen-type-1 in cavernous tissue and determined the effect of losartan in preventing fibrosis in priapism model of Wistar rats assessed by the metavir score.
METHODS
A total of eighteen male Wistar rats mean were divided into five groups. For the priapism models, we applied negative pressure on the penis to make an artificial erection to mimic the priapism process. The control groups were observed and the treatment groups were orally given losartan 15 mg/kg/day. was harvested for TGF-β1 and collagen-type-1 measurement using an enzyme-linked immunosorbent assay (ELISA). The fibrotic tissue of each rat was then collected and assessed histopathologically with the metavir scoring system.
RESULTS
Penile TGF-β1 concentration in the losartan-treated group was not significantly different on day 10 and day 28 of observation (p10=0,30; p28=0,17). Meanwhile, collagen-type-1 concentration was significantly lower compared to control group (p10=0,002; p28=0,01). There was a significant difference in metavir scores in rats that received losartan and those who did not (p<0,05).
CONCLUSION
Losartan could suppress the fibrosis process in the priapism model. It could decrease the collagen type 1 deposition during tissue regeneration. Based on the metavir score, the group receiving losartan therapy was better than the control group.
Topics: Humans; Male; Rats; Animals; Losartan; Angiotensin Receptor Antagonists; Priapism; Rats, Wistar; Transforming Growth Factor beta1; Angiotensin-Converting Enzyme Inhibitors; Penis; Fibrosis; Collagen
PubMed: 38046538
DOI: 10.12688/f1000research.123040.2 -
PloS One 2023Incontinence and sexual dysfunction are long-lasting side effects after surgical treatment (radical prostatectomy, RP) of prostate cancer (PC). For an informed treatment... (Observational Study)
Observational Study
BACKGROUND
Incontinence and sexual dysfunction are long-lasting side effects after surgical treatment (radical prostatectomy, RP) of prostate cancer (PC). For an informed treatment decision, physicians and patients should discuss expected impairments. Therefore, this paper firstly aims to develop and validate prognostic models that predict incontinence and sexual function of PC patients one year after RP and secondly to provide an online decision making tool.
METHODS
Observational cohorts of PC patients treated between July 2016 and March 2021 in Germany were used. Models to predict functional outcomes one year after RP measured by the EPIC-26 questionnaire were developed using lasso regression, 80-20 splitting of the data set and 10-fold cross validation. To assess performance, R2, RMSE, analysis of residuals and calibration-in-the-large were applied. Final models were externally temporally validated. Additionally, percentages of functional impairment (pad use for incontinence and firmness of erection for sexual score) per score decile were calculated to be used together with the prediction models.
RESULTS
For model development and internal as well as external validation, samples of 11 355 and 8 809 patients were analysed. Results from the internal validation (incontinence: R2 = 0.12, RMSE = 25.40, sexual function: R2 = 0.23, RMSE = 21.44) were comparable with those of the external validation. Residual analysis and calibration-in-the-large showed good results. The prediction tool is freely accessible: https://nora-tabea.shinyapps.io/EPIC-26-Prediction/.
CONCLUSION
The final models showed appropriate predictive properties and can be used together with the calculated risks for specific functional impairments. Main strengths are the large study sample (> 20 000) and the inclusion of an external validation. The models incorporate meaningful and clinically available predictors ensuring an easy implementation. All predictions are displayed together with risks of frequent impairments such as pad use or erectile dysfunction such that the developed online tool provides a detailed and informative overview for clinicians as well as patients.
Topics: Male; Humans; Erectile Dysfunction; Penile Erection; Urinary Incontinence; Prostatic Neoplasms; Prostatectomy
PubMed: 38039308
DOI: 10.1371/journal.pone.0295179 -
PloS One 2023Erectile dysfunction in patients who underwent radical prostatectomy was evaluated with pudendal somatosensory evoked potentials (PSEP) to measure and predict erectile...
Erectile dysfunction in patients who underwent radical prostatectomy was evaluated with pudendal somatosensory evoked potentials (PSEP) to measure and predict erectile dysfunction objectively. Fifty-seven patients who completed requirements were included in the study. Patients were divided into 2 groups (potency/non-potency). Erectile function recovery was defined as question 2 and 3 on the IIEF-5 questionnaire at 12 months after surgery. The two-channel PSEP test was performed at the day before RP and 3-6 months after RP. Twenty patients were assigned to the potency group and 37 to the non-potency group. Mean age was less in the potency group. Other clinical variables were similar in two groups. The non-potency group had prolonged lumbar and cortical latencies in postoperative PSEP, and the mean differences of latencies between pre- and postoperative PSEP in lumbar and cortical regions were also greater in the non-potency group. Logistic regression analysis showed that age, lumbar post-operative latency, cortical post-operative latency, and difference of latency in lumbar region were associated with non-potency; odds ratios were 1.292 (p = 0.018), 0.425 (p = 0.047), 1.637 (p < 0.001), and 3.272 (p = 0.010), respectively. This study suggests that PSEP is an effective means of evaluating erectile dysfunction in prostate cancer patients after surgery.
Topics: Male; Humans; Erectile Dysfunction; Prostate; Penile Erection; Prostatectomy; Prostatic Neoplasms; Recovery of Function
PubMed: 38019800
DOI: 10.1371/journal.pone.0292847 -
Basic and Clinical Andrology Nov 2023Few studies were conducted to explore the association between sleep quality and nocturnal erection. Here, we intended to explore the association between sleep quality...
BACKGROUND
Few studies were conducted to explore the association between sleep quality and nocturnal erection. Here, we intended to explore the association between sleep quality and nocturnal erection monitor when conducting nocturnal erection monitor. All erectile dysfunction (ED) patients underwent sleep monitors using Fitbit Charge 2™ (Fitbit Inc.) and nocturnal penile tumescence and rigidity (NPTR) monitors using RigiScan® (GOTOP medical, Inc., USA) for two nights. Subsequently, the patients were divided into two groups: Group A included patients who experienced effective erections only on the second night, while Group B included patients who had effective erections on both nights. To explore the associations between NPTR parameters and sleep parameters, a comparative analysis was performed between Group A and Group B for both nights.
RESULTS
Finally, our study included 103 participants, with 47 patients in Group A and 56 patients in Group B. Notably, the Group A patients showed significant improvements in NPTR parameters on the second night compared to the first night. Conversely, the NPTR parameters on Group B of the second night did not demonstrate a superior outcome when compared to the second night of Group A. Interestingly, it was found that only the disparities in sleep parameters accounted for the variation in NPTR parameters between the two groups on the first night. After correlation and ROC analysis, we identified the rapid eye movement (REM) sleep time and wake after sleep onset (WASO) time monitoring by the Fitbit Charge 2 as the primary parameters for predicting abnormal NPTR results in the first night.
CONCLUSIONS
Therefore, our study strongly suggests a close association between sleep parameters and NPTR parameters. It emphasizes the importance of incorporating sleep monitoring alongside nocturnal erection monitoring to enhance the reliability of the NPTR results.
PubMed: 38008740
DOI: 10.1186/s12610-023-00206-x -
Archivio Italiano Di Urologia,... Nov 2023to assess safety and efficacy of autologous mesenchymal bone marrow stem cell injection in penile cavernosal tissue for erectile dysfunction therapy in diabetic men.
PURPOSE
to assess safety and efficacy of autologous mesenchymal bone marrow stem cell injection in penile cavernosal tissue for erectile dysfunction therapy in diabetic men.
METHODS
The subjects of this study were diabetic men suffering erectile dysfunction, non-responding to maximum dose of oral PDE5I. Mesenchymal bone marrow stem cells were aspirated and injected after preparation in both corpora cavernosa at 3, 9 o'clock position. Erectile function was assessed by the International Index of Erectile Function and penile Doppler study, before and after 6 months after injection.
RESULTS
4 patients out of 10 achieve hard erection adequate for satisfactory coitus, and 2 patients achieved penile hardness with addition of pharmacological therapy with sildenafil 100mg. Peak systolic velocity increased significantly in 4 patients (2 arteriogenic and 2 mixed erectile dysfunction), from 12∼22 cm/s to 32∼69 cm/s. Variations in end-diastolic velocity increased substantially in 2 patients with venogenic insufficiency alone at follow-up from 4∼5 cm /s to -4∼-3 cm/s.
CONCLUSIONS
Despite promising stem cell treatment efficacy for patients with erectile dysfunction, more clinical studies and researches are still warranted.
Topics: Male; Humans; Erectile Dysfunction; Pilot Projects; Mesenchymal Stem Cell Transplantation; Penile Erection; Penis; Diabetes Mellitus
PubMed: 37990987
DOI: 10.4081/aiua.2023.11669 -
Translational Andrology and Urology Oct 2023Malignant priapism, a rare disease with only about 500 reported cases to date, consists of persistent erection secondary to invasion or metastasis of a primary neoplasm....
BACKGROUND
Malignant priapism, a rare disease with only about 500 reported cases to date, consists of persistent erection secondary to invasion or metastasis of a primary neoplasm. While treatment guidelines for priapism in non-malignant cases have been established, there is currently no guideline for treating malignant priapism. Herein, we describe three cases of malignant priapism and suggest a step-by-step approach for clinical management.
CASE DESCRIPTION
This study reports three cases of malignant priapism resulting from advanced genitourinary cancers. All patients experienced a sub-acute progression of penile pain and ultimately underwent palliative penectomy, resulting in sustained symptom relief.
CONCLUSIONS
Treatment of malignant priapism needs to be individualized to the needs of the patient. No matter the primary or secondary nature of the disease, current data suggest that malignant priapism is associated with poor outcomes and emphasis should be put on palliative care. Similar to previous cases, our cases died shortly after the diagnosis of malignant priapism. Conventional procedures such as shunting may not necessarily provide symptom relief in these patients. Although new radiation techniques have shown favorable outcomes, penectomy should be considered the last resort in clinical management. Revisions to the existing management guidelines for priapism are necessary to address its occurrence in malignant contexts.
PubMed: 37969781
DOI: 10.21037/tau-23-327 -
Investigative and Clinical Urology Nov 2023
Topics: Male; Humans; Mice; Animals; Erectile Dysfunction; Endothelial Cells; Penile Erection; Penis; Gene Expression Profiling; Diabetes Mellitus
PubMed: 37932572
DOI: 10.4111/icu.20230264 -
Clinics and Practice Oct 2023Peyronie's disease (PD) represents a challenging urological disease, due to not optimal post-operative surgical outcomes. We aim to retrospectively evaluate if vacuum...
BACKGROUND
Peyronie's disease (PD) represents a challenging urological disease, due to not optimal post-operative surgical outcomes. We aim to retrospectively evaluate if vacuum erection device (VED) treatment before penile curvature surgery is able to improve post-operative surgical outcomes.
METHODS
All enrolled patients were assigned to the following groups: (a) the treatment group: VED treatment (three times per week) starting 3 months before surgery and (three times per week) one month after surgery; and (b) the control group: VED treatment (three times per week) one month after surgery. Follow-up urologic visits were scheduled for 3 and 6 months after surgery, and the two groups were compared.
RESULTS
A total of 38 patients were enrolled (median age 67 years, 57-74, IQR): 20 in the treatment group and 18 in the control group. At the follow-up visits, the two groups were different in terms of IIEF-5 (26 vs. 24; = 0.02), "yes" to SEP2 and 3 (85% vs. 55%; < 0.001, 85% vs. 50%; < 0.001, respectively), and PDQ (-16 vs. -11; = 0.03). Complete correction of penile curvature was achieved in 36 patients (94.7%). In the treatment group, no hourglass deformity was reported, whereas one patient reported a mild hourglass deformity in the control group. In the treatment group, we obtained a longer total penile length (median +1.5 cm). The overall satisfaction rate was 98% in the treatment group and 96% in the control group.
CONCLUSIONS
The VED treatment before penile curvature surgery in patients affected by PD was able to improve surgical outcomes.
PubMed: 37887088
DOI: 10.3390/clinpract13050112 -
Asian Journal of Andrology Nov 2023
Topics: Humans; Male; COVID-19; East Asian People; Erectile Dysfunction; Pandemics; Penile Erection; Prostatitis; Sickness Impact Profile
PubMed: 37800905
DOI: 10.4103/aja202347 -
Scientific Reports Oct 2023Penile size is closely concerned and short penis contributes serious sexual dysfunction and tremendous psychological problems to couples. Androgen is essential for...
Penile size is closely concerned and short penis contributes serious sexual dysfunction and tremendous psychological problems to couples. Androgen is essential for penile development and testosterone replacement is recommended to patients with micropenis. We previously proved that inhibiting activity of lysyl oxidase (Anti-lysyl oxidase, Anti-LOX) combined with vacuum erectile device (VED) lengthened penis by remodeling tunica albuginea. We thus explored whether HCG supplement could accelerate tunica albuginea remodeling (induced by Anti-LOX + VED) to promote penile growth. Forty-two SD male rats (4 weeks old) were purchased and divided into 7 groups: control, Anti-LOX, HCG, VED (with a negative aspirated pressure of - 300 mmHg), Anti-LOX + VED, HCG + VED, and Anti-LOX + HCG + VED. After an intervention for 4 weeks, all rats' penile length, exposed penile length, and erectile function were measured. Serum samples were collected to detect hormone levels and penile corpus cavernosum were harvested for histo-pathological analysis. All intervention groups showed significantly longer penis than controlled rats. Anti-LOX sharply increased penile length and exposed length by 15% and 9% respectively, this lengthening effect was more obvious in Anti-LOX + VED group (26% and 19%, respectively). Although HCG promoted penile length by 8%, this effect was slight for exposed length (3%). Moreover, Anti-LOX + HCG + VED dramatically increased penile length and exposed length by 22% and 18%, respectively, which was similar with that in Anti-LOX + VED (26% and 19%, respectively). HCG dramatically stimulated testosterone and dihydrotestosterone secretions than control group, whether with or without Anti-LOX and VED; while it induced more AR expression than other groups. Finally, all procedures did not improve or deteriorate normal erectile function. Although we verified that Anti-LOX + VED lengthened penis by inducing tunica albuginea remodeling, however, HCG supplement did not synergize with Anti-LOX + VED to accelerate albuginea remodeling to facilitate penile growth.
Topics: Humans; Male; Rats; Animals; Erectile Dysfunction; Penis; Penile Erection; Testosterone
PubMed: 37783699
DOI: 10.1038/s41598-023-38888-y