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Nature Reviews. Disease Primers Feb 2016Erectile dysfunction is a multidimensional but common male sexual dysfunction that involves an alteration in any of the components of the erectile response, including... (Review)
Review
Erectile dysfunction is a multidimensional but common male sexual dysfunction that involves an alteration in any of the components of the erectile response, including organic, relational and psychological. Roles for nonendocrine (neurogenic, vasculogenic and iatrogenic) and endocrine pathways have been proposed. Owing to its strong association with metabolic syndrome and cardiovascular disease, cardiac assessment may be warranted in men with symptoms of erectile dysfunction. Minimally invasive interventions to relieve the symptoms of erectile dysfunction include lifestyle modifications, oral drugs, injected vasodilator agents and vacuum erection devices. Surgical therapies are reserved for the subset of patients who have contraindications to these nonsurgical interventions, those who experience adverse effects from (or are refractory to) medical therapy and those who also have penile fibrosis or penile vascular insufficiency. Erectile dysfunction can have deleterious effects on a man's quality of life; most patients have symptoms of depression and anxiety related to sexual performance. These symptoms, in turn, affect his partner's sexual experience and the couple's quality of life. This Primer highlights numerous aspects of erectile dysfunction, summarizes new treatment targets and ongoing preclinical studies that evaluate new pharmacotherapies, and covers the topic of regenerative medicine, which represents the future of sexual medicine.
Topics: Aging; Alcohol Drinking; Endocrine System Diseases; Erectile Dysfunction; Humans; Male; Penis; Quality of Life; Risk Factors; Smoking
PubMed: 27188339
DOI: 10.1038/nrdp.2016.3 -
American Family Physician Nov 2016Erectile dysfunction (ED) is the inability to achieve or maintain an erection sufficient for satisfactory sexual performance. It is common, affecting at least 12 million...
Erectile dysfunction (ED) is the inability to achieve or maintain an erection sufficient for satisfactory sexual performance. It is common, affecting at least 12 million U.S. men. The five-question International Index of Erectile Function allows rapid clinical assessment of ED. The condition can be caused by vascular, neurologic, psychological, and hormonal factors. Common conditions related to ED include diabetes mellitus, hypertension, hyperlipidemia, obesity, testosterone deficiency, and prostate cancer treatment. Performance anxiety and relationship issues are common psychological causes. Medications and substance use can cause or exacerbate ED; antidepressants and tobacco use are the most common. ED is associated with an increased risk of cardiovascular disease, particularly in men with metabolic syndrome. Tobacco cessation, regular exercise, weight loss, and improved control of diabetes, hypertension, and hyperlipidemia are recommended initial lifestyle interventions. Oral phosphodiesterase-5 inhibitors are the firstline treatments for ED. Second-line treatments include alprostadil and vacuum devices. Surgically implanted penile prostheses are an option when other treatments have been ineffective. Counseling is recommended for men with psychogenic ED.
Topics: Alprostadil; Chronic Disease; Erectile Dysfunction; Exercise; Healthy Lifestyle; Humans; Male; Penile Prosthesis; Phosphodiesterase 5 Inhibitors; Tobacco Use Cessation; Vacuum; Vasodilator Agents; Weight Loss
PubMed: 27929275
DOI: No ID Found -
F1000Research 2019Erectile dysfunction (ED) is important to a man's well-being and health, since it not only affects the individual but also causes strain on a couple's lifestyle and... (Review)
Review
Erectile dysfunction (ED) is important to a man's well-being and health, since it not only affects the individual but also causes strain on a couple's lifestyle and relationship. There are multiple non-invasive treatments that exist for ED including lifestyle changes, oral medications (phosphodiesterase type 5 inhibitors), vacuum-assisted erectile devices, and intraurethral suppositories. While lifestyle changes and oral medications are typically first-line treatments for ED, more-invasive treatments including intracavernosal injections and surgically implanted prosthetic devices may be required for the management of complex cases. Additionally, novel therapies are currently being developed, and future treatment options may include shock-wave therapy, external prosthetic devices, and injection of stem cells or platelet-rich plasma. The current manuscript seeks to highlight advances in management and may eventually alter the treatment paradigm to allow more-inclusive care pathways.
Topics: Erectile Dysfunction; Humans; Male; Penile Prosthesis; Phosphodiesterase 5 Inhibitors; Vacuum
PubMed: 30740217
DOI: 10.12688/f1000research.16576.1 -
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 -
Cells Jan 2022Lithium has been a mainstay of therapy for patients with bipolar disorders for several decades. However, it may exert a variety of adverse effects that can affect... (Review)
Review
Lithium has been a mainstay of therapy for patients with bipolar disorders for several decades. However, it may exert a variety of adverse effects that can affect patients' compliance. Sexual and erectile dysfunction has been reported in several studies by patients who take lithium as monotherapy or combined with other psychotherapeutic agents. The exact mechanisms underlying such side effects of lithium are not completely understood. It seems that both central and peripheral mechanisms are involved in the lithium-related sexual dysfunction. Here, we had an overview of the epidemiology of lithium-related sexual and erectile dysfunction in previous clinical studies as well as possible pathologic pathways that could be involved in this adverse effect of lithium based on the previous preclinical studies. Understanding such mechanisms could potentially open a new avenue for therapies that can overcome lithium-related sexual dysfunction and improve patients' adherence to the medication intake.
Topics: Animals; Disease Models, Animal; Erectile Dysfunction; Humans; Lithium; Male; Models, Biological
PubMed: 35011733
DOI: 10.3390/cells11010171 -
Asian Journal of Andrology 2015Erectile dysfunction (ED) is a form of sexual dysfunction that is estimated to affect > 30% of men between the ages of 40 and 70. As a result of an improved...
Erectile dysfunction (ED) is a form of sexual dysfunction that is estimated to affect > 30% of men between the ages of 40 and 70. As a result of an improved understanding about the pathophysiology of ED and improved treatment options, an increasing number of men are presenting for evaluation than several decades ago. In fact, many of these men are visiting their health care professional for the first time with ED as their primary complaint. Most of these men are unaware of the link between ED and cardiovascular disease (CVD).
Topics: Cardiovascular Diseases; Erectile Dysfunction; Humans; Impotence, Vasculogenic; Life Style; Male; Prevalence; Risk Factors; Stents; Testosterone
PubMed: 25532581
DOI: 10.4103/1008-682x.143753 -
Ugeskrift For Laeger Jan 2020This review covers the possible treatment modalities of organic erectile dysfunction (ED). About 30% of men over 40 years of age suffer from ED. At diagnosis, organic ED... (Review)
Review
This review covers the possible treatment modalities of organic erectile dysfunction (ED). About 30% of men over 40 years of age suffer from ED. At diagnosis, organic ED should be distinguished from psychological ED, and it is crucial to identify underlying diseases including endocrine disorders, neurological problems and cardiovascular diseaplase. Management of organic ED is initiated by treating such underlying problems, and lifestyle changes are central. Symptomatic treatments include tablets, injections, intraurethral medication, vacuum pumps, and penile implants. Current research focuses on regenerative medicine, which may play a future role.
Topics: Erectile Dysfunction; Humans; Injections; Male; Penile Prosthesis
PubMed: 32052735
DOI: No ID Found -
Frontiers in Public Health 2022Chronic liver diseases (CLDs) are characterized by progressive necrosis of hepatocytes, which leads to liver fibrosis and cirrhosis, and ultimately liver dysfunction.... (Review)
Review
Chronic liver diseases (CLDs) are characterized by progressive necrosis of hepatocytes, which leads to liver fibrosis and cirrhosis, and ultimately liver dysfunction. The statistics of 2020 shows that the number of patients with CLDs, including chronic hepatitis, fatty liver, and cirrhosis, may exceed 447 million in China. The liver is a crucial organ for the metabolism of various substances, including sex hormones and lipids. CLDs frequently result in abnormalities in the metabolism of sex hormones, glucose, and lipids, as well as mental and psychological illnesses, all of which are significant risk factors for erectile dysfunction (ED). It has been reported that the prevalence of ED in male patients with CLDs ranges from 24.6 to 85.0%. According to a survey of Caucasians, liver transplantation may improve the erectile function of CLDs patients with ED. This finding supports the link between CLDs and ED. In addition, ED is often a precursor to a variety of chronic diseases. Given this correlation and the significant prevalence of CLDs, it is important to evaluate the epidemiology, risk factors, etiology, and treatment outcomes of ED in male patients with CLDs, expecting to attract widespread attention.
Topics: Male; Humans; Erectile Dysfunction; Risk Factors; Liver Cirrhosis; Gonadal Steroid Hormones; Lipids
PubMed: 36684968
DOI: 10.3389/fpubh.2022.1092353 -
Asian Journal of Andrology Jan 2013Contemporary therapies for erectile dysfunction are generally targeted towards older men and universally engage pharmacological and/or device related treatment options.... (Review)
Review
Contemporary therapies for erectile dysfunction are generally targeted towards older men and universally engage pharmacological and/or device related treatment options. Penile revascularization, using microvascular arterial bypass surgical techniques, is a non-pharmacological, non-device-related, and reconstructive surgical strategy for men with erectile dysfunction that was first described by Dr Vaclav Michal in 1973. Contemporary penile revascularization attempts to 'cure' pure arteriogenic erectile dysfunction in young men with arterial occlusive pathology in the distal internal pudendal, common penile or proximal cavernosal artery secondary to focal endothelial injury from blunt pelvic, perineal or penile trauma. A microvascular anastomosis is fashioned between the donor inferior epigastric and recipient dorsal penile artery. Increased perfusion pressure is theoretically communicated to the cavernosal artery via perforating branches from the dorsal artery. This article will review the history, indications and pathophysiology of blunt trauma-induced focal arterial occlusive disease in young men with erectile dysfunction, current surgical techniques utilized and results of surgery. Contemporary use of penile revascularization is a logical and wanted therapeutic option to attempt to reverse erectile dysfunction in young men who have sustained blunt pelvic, perineal or penile trauma.
Topics: Adult; Arterial Occlusive Diseases; Erectile Dysfunction; Humans; Impotence, Vasculogenic; Male; Middle Aged; Pelvis; Penis; Perineum; Vascular Surgical Procedures; Wounds, Nonpenetrating
PubMed: 23241636
DOI: 10.1038/aja.2012.146 -
American Family Physician Nov 2016
Topics: Age Distribution; Aged; Chronic Disease; Drug Therapy; Erectile Dysfunction; Exercise; Healthy Lifestyle; Humans; Male; Middle Aged; Tobacco Use Cessation; Weight Loss
PubMed: 27929283
DOI: No ID Found