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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 -
Clinical Case Reports Oct 2023High-flow priapism in pediatric population is rare, yet comprehensive clinical evaluation, along with penile Doppler ultrasound, and cavernosal blood analysis are...
KEY CLINICAL MESSAGE
High-flow priapism in pediatric population is rare, yet comprehensive clinical evaluation, along with penile Doppler ultrasound, and cavernosal blood analysis are crucial for accurate diagnosis. Conservative therapy is effective as an initial treatment.
ABSTRACT
High-flow priapism is considerably rare in the pediatric age group. We report a four-month-old infant presented with a prolonged penile erection. Diagnostic confirmation was achieved through the utilization of Doppler ultrasound and cavernous blood gas analysis. We also review published data on the management of this condition.
PubMed: 37780917
DOI: 10.1002/ccr3.7985 -
International Journal of Impotence... Nov 2023Genital gender affirmation surgery (gGAS) for individuals assigned female at birth (AFAB) is complex and requires the staged insertion of an erectile device to permit... (Review)
Review
Genital gender affirmation surgery (gGAS) for individuals assigned female at birth (AFAB) is complex and requires the staged insertion of an erectile device to permit penetrative intercourse. This final stage of gGAS is challenging, owing to the variable anatomy and lack of supportive structures within the neophallus when compared with erectile device insertion for individuals assigned male at birth. There is a paucity in the literature at present regarding erectile device insertion in trans-sex AFAB patients. Hence, a narrative review following a literature review and supplemented by expert opinion from a high-volume centre of expertise is presented. The choices available for erectile device in this patient cohort are discussed. Principle surgical steps required for this complex surgery is outlined along with the recommended postoperative management of the patient. Postoperative outcomes and complications are also summarised in this fast-developing surgical procedure.
Topics: Infant, Newborn; Humans; Male; Female; Transgender Persons; Penis; Phalloplasty; Transsexualism; Penile Erection; Sex Reassignment Surgery
PubMed: 37736758
DOI: 10.1038/s41443-023-00764-8