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Frontiers in Pharmacology 2024Priapism, defined as a prolonged and often painful penile erection occurring without sexual stimulation or desire, is a common complication in sickle cell disease (SCD),... (Review)
Review
Priapism, defined as a prolonged and often painful penile erection occurring without sexual stimulation or desire, is a common complication in sickle cell disease (SCD), affecting up to 48% of male patients. This condition presents significant clinical challenges and can lead to erectile dysfunction if not properly managed. Current pharmacological treatments for SCD-related priapism are primarily reactive rather than preventative, highlighting a gap in effective medical intervention strategies. A critical factor in developing priapism is the reduced basal bioavailability of nitric oxide (NO) and cyclic guanosine monophosphate (cGMP) in erectile tissues. New prevention strategies should ideally target the underlying pathophysiology of the disease. Compounds that stimulate and activate soluble guanylate cyclase (sGC) emerge as potential therapeutic candidates since these compounds have the property of inducing cGMP production by sGC. This review explores the potential of sGC stimulators and activators in treating priapism associated with SCD. We discuss the advantages of these agents in the face of the challenging pathophysiology of SCD. Additionally, the review underscores the impact of intravascular hemolysis and oxidative stress on priapism pathophysiology in SCD, areas in which sGC stimulators and activators may also have beneficial therapeutic effects.
PubMed: 38384294
DOI: 10.3389/fphar.2024.1357176 -
Reproductive Sciences (Thousand Oaks,... Feb 2024Male fertility and metabolic disorders, including obesity and diabetes, are closely connected. Since hyperuricemia and metabolic syndrome are strongly related, male... (Review)
Review
Male fertility and metabolic disorders, including obesity and diabetes, are closely connected. Since hyperuricemia and metabolic syndrome are strongly related, male fertility and hyperuricemia may, to some degree, be associated. According to recent studies, hyperuricemia imposes various effects on sex hormones, semen quality, and male erectile dysfunction. Some researchers claim that uric acid worsens male semen and raises the risk of erectile dysfunction (ED), while others state that it safeguards both penile erection and male semen. Additionally, it has been shown that gout and metabolic syndrome also raise the risk of ED. To clarify this controversy, the influence and potential mechanisms of hyperuricemia on ED, semen quality, sex hormone levels, and the effects of hyperuricemia-related disorders on ED will be comprehensively summarized.
PubMed: 38379071
DOI: 10.1007/s43032-024-01453-7 -
Archivos Espanoles de Urologia Jan 2024In this article, the associated factors for erectile dysfunction (ED) after radical prostatectomy (RP) were explored, and a clinical risk assessment model was...
OBJECTIVE
In this article, the associated factors for erectile dysfunction (ED) after radical prostatectomy (RP) were explored, and a clinical risk assessment model was constructed.
METHODS
A total of 155 patients who underwent RP in People's Hospital of Hunan Province from November 2020, to November 2021, were selected as the study group. In accordance with the results of International Index of Erectile Function (IIEF-5) at 6 months after surgery, 88 patients were included in the ED group (IIEF-5 <22), and 67 patients were included in the non-ED group (IIEF-5 ≥22). Univariate and multivariate logistic regression analyses were conducted to screen the risk factors for ED after RP, and a risk model was constructed on this basis. In addition, 43 patients with ED after RP and 41 patients with non-ED after RP from January 2022, to January 2023, were included in the test group to evaluate the predictive efficacy of the clinical risk assessment model on the basis of the receiver operating characteristic curve.
RESULTS
The study group had a lower postoperative IIEF-5 score than before surgery ( < 0.001). The incidence of ED after RP in the study group was 56.77% (88/155). Multivariate analysis showed that advanced age (odds ratio (OR) = 1.155), large prostate volume (OR = 1.077), smoking (OR = 5.676), drinking (OR = 3.495), hypertension (OR = 8.079), diabetes (OR = 6.082), low preoperative serum testosterone (T) level (OR = 0.684) and high preoperative serum endothelin-1 (ET-1) level (OR = 1.192) were risk factors for ED after RP ( < 0.05). A risk model was constructed as follows: Z = 0.144 × (age) + 0.074 × (prostate volume) + 1.736 × (smoking) + 1.251 × (drinking) + 2.089 × (hypertension) + 1.805 × (diabetes) - 0.380 × (preoperative serum T) + 0.175 × (preoperative serum ET-1). The area under curve (AUC), sensitivity, specificity and 95% CI of this model were 0.906, 97.70%, 73.20%, and 0.848-0.964, respectively ( < 0.001).
CONCLUSIONS
The clinical risk assessment model constructed on the basis of the above factors provides some references for the scientific prevention and treatment of ED after RP.
Topics: Male; Humans; Infant, Newborn; Erectile Dysfunction; Prostate; Retrospective Studies; Prostatic Neoplasms; Prostatectomy; Risk Assessment; Risk Factors; Diabetes Mellitus; Hypertension; Penile Erection
PubMed: 38374018
DOI: 10.56434/j.arch.esp.urol.20247701.12 -
Zhongguo Zhen Jiu = Chinese Acupuncture... Feb 2024To observe the clinical efficacy of heat-sensitive moxibustion combined with powder in treating erectile dysfunction with kidney deficiency and blood stasis. (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVES
To observe the clinical efficacy of heat-sensitive moxibustion combined with powder in treating erectile dysfunction with kidney deficiency and blood stasis.
METHODS
A total of 80 patients with erectile dysfunction of kidney deficiency and blood stasis were randomly divided into a comprehensive group (40 cases, 1 case dropped out) and a Chinese herb group (40 cases, 2 cases dropped out). In the Chinese herb group, powder was applied orally, one dose per day. On the basis of the Chinese herb group, heat-sensitive moxibustion was applied after detecting the heat-sensitive points in the areas of Guanyuan (CV 4), Zhongji (CV 3), Qihai (CV 6) and bilateral Xuehai (SP 10), Sanyinjiao (SP 6) in the comprehensive group, once a day, 5 times a week. Both groups were treated for 4 weeks. The international index of erectile function-5 (IIEF-5) score, erectile hardness score (EHS), nocturnal penile tumescence and rigidity (NPTR) indexes (nocturnal penile erection frequency, total duration of penile erection, duration of penile head hardness ≥60%, duration of penile root hardness ≥60%, percentage change in penile head circumference, percentage change in penile root circumference), TCM syndrome score, and penile vascular function indexes (peak systolic velocity [PSV], end diastolic velocity [EDV], and resistance index [RI] of penile cavernosal artery) were compared in the patients of the two groups before and after treatment, and the clinical efficacy was evaluated.
RESULTS
After treatment, the IIEF-5 scores, EHS, PSV, RI, and NPTR indexes were increased compared with those before treatment (<0.01), while the TCM syndrome scores and EDV were decreased compared with those before treatment (<0.01) in the two groups.The IIEF-5 score, EHS, PSV, RI, and NPTR indexes in the comprehensive group were ascended compared with those in the Chinese herb group (<0.01), while the TCM syndrome score and EDV in the comprehensive group were lower than those in the traditional Chinese herb group (0.01). The total effective rate of the comprehensive group was 94.9% (37/39), which was higher than 78.9% (30/38, <0.05) of the Chinese herb group.
CONCLUSIONS
The combination of heat-sensitive moxibustion and powder can effectively treat erectile dysfunction of kidney deficiency and blood stasis, improve patients' erectile function, enhance their erection hardness, and improve their penile vascular function and clinical symptoms.
Topics: Male; Humans; Erectile Dysfunction; Moxibustion; Powders; Hot Temperature; Kidney
PubMed: 38373758
DOI: 10.13703/j.0255-2930.20230409-0004 -
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 -
International Journal of Clinical and... 2024Men do not use external condoms for several reasons, which can result in public health problems. One of these is related to Condom-Associated Erectile Problems. This...
BACKGROUND/OBJECTIVE
Men do not use external condoms for several reasons, which can result in public health problems. One of these is related to Condom-Associated Erectile Problems. This study aimed to examine the sexual arousal response of heterosexual men when using an external condom made of synthetic resin type AT-10.
METHOD
A total of 82 Colombian young men (age = 23.17 years, = 3.04, age range = 18-30) participated in this experimental study. Two random groups (experimental and control; = 41 each) were compared. The experimental group used condoms, whereas the control group did not. Fit and feel condom perceptions, initial erectile scores, age, and substance use were controlled for. Erection was measured while viewing a sexual video by using penile plethysmography and subjective arousal.
RESULTS
The results, obtained from comparing the experimental group (using pre-erection condoms) with the control group (not using condoms), revealed no significant difference in both subjective and physiological sexual arousal. This suggests that pre-erection condoms do not have an effect on the erectile response.
DISCUSSION
More research is needed in this area to provide treatment and clinical interventions or sexual and reproductive education to mitigate the occurrence of sexual dysfunction, unplanned pregnancies, or sexually transmitted infections. Also, research addresses public health issues related to the prevention and/or intervention of sexual risk behaviors and sexual dysfunctions, highlighting their significance in sexual education and clinical practice.
PubMed: 38348144
DOI: 10.1016/j.ijchp.2024.100442 -
Frontiers in Behavioral Neuroscience 2023In the presented review, we analyzed the physiology of male sexual arousal and its relation to the motivational aspects of this behavior. We highlighted the distinction... (Review)
Review
In the presented review, we analyzed the physiology of male sexual arousal and its relation to the motivational aspects of this behavior. We highlighted the distinction between these processes based on observable physiological and behavioral parameters. Thus, we proposed the experimentally applicable differentiation between sexual arousal (SA) and sexual motivation (SM). We propose to define sexual arousal as an overall autonomic nervous system response leading to penile erection, triggered selectively by specific sexual cues. These autonomic processes include both spinal and supraspinal neuronal networks, activated by sensory pathways including information from sexual partner and sexual context, as well as external and internal genital organs. To avoid misinterpretation of experimental data, we also propose to precise the term "sexual motivation" as all actions performed by the individual that increase the probability of sexual interactions or increase the probability of exposition to sexual context cues. Neuronal structures such as the amygdala, bed nucleus of stria terminalis, hypothalamus, nucleus raphe, periaqueductal gray, and nucleus paragigantocellularis play crucial roles in controlling the level of arousal and regulating peripheral responses via specific autonomic effectors. On the highest level of CNS, the activity of cortical structures involved in the regulation of the autonomic nervous system, such as the insula and anterior cingulate cortex, can visualize an elevated level of SA in both animal and human brains. From a preclinical perspective, we underlie the usefulness of the non-contact erection test (NCE) procedure in understanding factors influencing sexual arousal, including studies of sexual preference in animal models. Taken together results obtained by different methods, we wanted to focus attention on neurophysiological aspects that are distinctly related to sexual arousal and can be used as an objective parameter, leading to higher translational transparency between basic, preclinical, and clinical studies.
PubMed: 38333545
DOI: 10.3389/fnbeh.2023.1330460 -
Science (New York, N.Y.) Feb 2024Perivascular fibroblasts may underlie erectile dysfunction.
Perivascular fibroblasts may underlie erectile dysfunction.
Topics: Humans; Male; Erectile Dysfunction; Excitatory Amino Acid Transporter 1; Fibroblasts; Penile Erection; Mice; Animals
PubMed: 38330119
DOI: 10.1126/science.adn5182 -
Science (New York, N.Y.) Feb 2024Penile erection is mediated by the corpora cavernosa, a trabecular-like vascular bed that enlarges upon vasodilation, but its regulation is not completely understood....
Penile erection is mediated by the corpora cavernosa, a trabecular-like vascular bed that enlarges upon vasodilation, but its regulation is not completely understood. Here, we show that perivascular fibroblasts in the corpora cavernosa support vasodilation by reducing norepinephrine availability. The effect on penile blood flow depends on the number of fibroblasts, which is regulated by erectile activity. Erection dynamically alters the positional arrangement of fibroblasts, temporarily down-regulating Notch signaling. Inhibition of Notch increases fibroblast numbers and consequently raises penile blood flow. Continuous Notch activation lowers fibroblast numbers and reduces penile blood perfusion. Recurrent erections stimulate fibroblast proliferation and limit vasoconstriction, whereas aging reduces the number of fibroblasts and lowers penile blood flow. Our findings reveal adaptive, erectile activity-dependent modulation of penile blood flow by fibroblasts.
Topics: Animals; Male; Mice; Blood Circulation; Excitatory Amino Acid Transporter 1; Fibroblasts; Mice, Inbred BALB C; Mice, Inbred C57BL; Mice, Transgenic; Penile Erection; Penis; Receptors, Notch; Signal Transduction; Vasoconstriction; Vasodilation
PubMed: 38330107
DOI: 10.1126/science.ade8064