Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 2.162
Filtrar
1.
Medicine (Baltimore) ; 99(15): e19718, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32282728

RESUMO

INTRODUCTION: Erectile dysfunction refers to the continued inability of the penis to reach and maintain sufficient erections to achieve a satisfactory sex life and last at least 6 months. As part of traditional Chinese medicine, acupuncture has been widely used in clinical practice. In order to evaluate, the exact effect of acupuncture on the clinical efficacy of patients with Post-stroke Erectile dysfunction (PSED), this experiment uses randomized controlled experiments. METHODS/DESIGN: This pragmatic randomized controlled trial will recruit 103 patients who are diagnosed with PSED. Simple randomization to conventional treatment with a 1:1 allocation ratio will be used. Ten 30-min acupuncture sessions will be provided to patients assigned to the Intervention group. All participants will continue to receive conventional treatment. The selection of outcomes will be evaluated by International Erectile Function Index-5 (IIEF-5) score at week 8. DISCUSSION: This trial may provide evidence regarding the clinical effectiveness, safety, and cost-effectiveness of acupuncture for patients with PSED. TRIAL REGISTRATION: ClinicalTrials.gov, ChiCTR2000030231, Registered on February 25, 2020.


Assuntos
Terapia por Acupuntura/métodos , Disfunção Erétil/terapia , Acidente Vascular Cerebral/fisiopatologia , Terapia por Acupuntura/economia , Adulto , Análise Custo-Benefício , Disfunção Erétil/diagnóstico , Disfunção Erétil/etiologia , Humanos , Masculino , Medicina Tradicional Chinesa , Pessoa de Meia-Idade , Acidente Vascular Cerebral/complicações , Resultado do Tratamento
2.
J Urol ; 203(4): 792-801, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31763948

RESUMO

PURPOSE: In a preliminary clinical trial we assessed the efficacy of ejaculatory hood sparing GreenLight™ Laser prostate photoselective vaporization to preserve antegrade ejaculation and urodynamic relief of obstruction compared to standard GreenLight prostate photoselective vaporization. MATERIALS AND METHODS: Standard prostate photoselective vaporization was classically performed in 24 patients. Ejaculatory hood sparing vaporization was performed with preservation of the paracollicular and supracollicular tissue proximal to the verumontanum in 25 patients. Patients were assessed at baseline, and 1, 3, 6 and 12 months postoperatively using the Ej-MSHQ (Ejaculatory Domain of Male Sexual Health Questionnaire) and the IIEF-15 (International Index of Erectile Function-15). The I-PSS (International Prostate Symptom Score), uroflowmetry and post-void residual urine volume were reported at each followup visit. A standard urodynamic study was performed at 6 months. RESULTS: Antegrade ejaculation was reported in 85% and 31.6% of patients after hood sparing and standard prostate vaporization, respectively (p=0.001). A significant reduction in the EJ-MSHQ score was reported after standard vaporization at 6 and 12 months (each p <0.001) with no significant difference after hood sparing vaporization (p=0.18 and 0.078, respectively). The median EJ-MSHQ score was 28.5 (range 1 to 33) and 27 (range 1 to 33) for hood sparing vaporization, and 9.5 (range 1 to 35) and 9 (range 0 to 33) for standard vaporization at 6 (p=0.005) and 12 months (p <0.001), respectively. Each group showed a decline in the mean total IIEF-15 score at 1 year but it was statistically significant only after standard vaporization (p=0.001). All urinary outcome measures revealed comparable significant improvement at all followups. Postoperative urodynamic assessment demonstrated a significant comparable decrease in the Bladder Outlet Obstruction Index from a median of 64 (range 21 to 207) to 23.5 (range 10 to 53) after hood sparing vaporization (p=0.005) and from 87 (range 38 to 186) to 19.5 (range 7 to 51) after standard vaporization (p=0.001). At 1 year the overall re-treatment rate was comparable in the 2 groups (p=0.26). CONCLUSIONS: In well informed, sexually interested patients ejaculatory hood sparing GreenLight prostate photoselective vaporization is feasible and effective treatment of small to moderate sized benign prostatic hyperplasia with a superior sexual function related outcome. Short-term relief of obstruction is objectively comparable to that of standard prostate photoselective vaporization.


Assuntos
Disfunção Erétil/diagnóstico , Terapia a Laser/efeitos adversos , Tratamentos com Preservação do Órgão/efeitos adversos , Complicações Pós-Operatórias/diagnóstico , Prostatectomia/efeitos adversos , Hiperplasia Prostática/cirurgia , Método Duplo-Cego , Ejaculação/fisiologia , Disfunção Erétil/etiologia , Disfunção Erétil/fisiopatologia , Disfunção Erétil/prevenção & controle , Estudos de Viabilidade , Seguimentos , Humanos , Terapia a Laser/instrumentação , Terapia a Laser/métodos , Lasers de Estado Sólido/efeitos adversos , Lasers de Estado Sólido/uso terapêutico , Masculino , Pessoa de Meia-Idade , Tratamentos com Preservação do Órgão/métodos , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/fisiopatologia , Complicações Pós-Operatórias/prevenção & controle , Próstata/patologia , Próstata/cirurgia , Prostatectomia/métodos , Hiperplasia Prostática/patologia , Fatores de Tempo , Resultado do Tratamento , Urodinâmica/fisiologia
3.
Urology ; 135: 66-70, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31541647

RESUMO

OBJECTIVE: To define age-specific normal Color Doppler Duplex Ultrasound (CDDU) parameters based on a large institutional database of men referred for vascular erectile testing, but found to have normal and sustained rigidity following penile injection of alprostadil. METHODS: A retrospective review of patients who underwent CDDU from January 1, 2005 to December 31, 2014 was conducted. The indications for CDDU assessments included complaint of erectile dysfunction refractory to PDE-5 inhibitors, new-onset penile curvature, or secondary consultation for erectile dysfunction. Pearson correlation test was used to evaluate the association between ordinal age groups with peak systolic velocity (PSV) and resistive index (RI) measurements to determine the effect of age on erectile response. RESULTS: A total of 2043 patients underwent CDDU from January 1, 2005 to December 31, 2014. 259 patients (12.7%) with a mean age 53.7 and a mean BMI of 27.2 were noted to have normal erectile rigidity and normal Doppler parameters (PSV >35 cm/s, RI >0.90). Prolonged erection, defined by need to inject phenylephrine reversal agent at 1-2 hours, occurred in 93% of patients. When age was categorized by decade, a negative correlation coefficient was obtained for previsual sexual stimulation PSV (-0.09, P = .164) and postvisual sexual stimulation PSV (-0.23, P = .005). CONCLUSION: In men with normal vascular erections there appears to be a significant, age-related decline in postvisual sexual stimulation PSV without compromise to cavernous venous occlusion as measured by RI. We have used Doppler parameters in patients without vascular ED to define age-specific normalcy.


Assuntos
Envelhecimento/fisiologia , Disfunção Erétil/diagnóstico , Ereção Peniana/fisiologia , Pênis/diagnóstico por imagem , Ultrassonografia Doppler em Cores , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Disfunção Erétil/tratamento farmacológico , Disfunção Erétil/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Ereção Peniana/efeitos dos fármacos , Pênis/irrigação sanguínea , Pênis/fisiologia , Fenilefrina/administração & dosagem , Fenilefrina/antagonistas & inibidores , Inibidores da Fosfodiesterase 5/farmacologia , Inibidores da Fosfodiesterase 5/uso terapêutico , Estudos Retrospectivos , Falha de Tratamento , Agentes Urológicos/uso terapêutico , Adulto Jovem
4.
Urology ; 135: 111-116, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31454660

RESUMO

OBJECTIVE: To explore relationships between dose to periprostatic anatomic structures and erectile dysfunction (ED) outcomes in an institutional cohort treated with prostate brachytherapy. METHODS: The Sexual Health Inventory for Men (SHIM) instrument was administered for stage cT1-T2 prostate cancer patients treated with Pd-103 brachytherapy over a 10-year interval. Dose volume histograms for regional organs at risk and periprostatic regions were calculated with and without expansions to account for contouring uncertainty. Regression tree analysis clustered patients into ED risk groups. RESULTS: We identified 115 men treated with definitive prostate brachytherapy who had 2 years of complete follow-up. On univariate analysis, the subapical region (SAR) caudal to prostate was the only defined region with dose volume histograms parameters significant for potency outcomes. Regression tree analysis separated patients into low ED risk (mean 2-year SHIM 20.03), medium ED risk (15.02), and high ED risk (5.54) groups. Among patients with good baseline function (SHIM ≥ 17), a dose ≥72.75 Gy to 20% of the SAR with 1 cm expansion was most predictive for 2-year potency outcome. On multivariate analysis, regression tree risk group remained significant for predicting potency outcomes even after adjustment for baseline SHIM and age. CONCLUSION: Dose to the SAR immediately caudal to prostate was predictive for potency outcomes in patients with good baseline function. Minimization of dose to this region may improve potency outcomes following prostate brachytherapy.


Assuntos
Braquiterapia/efeitos adversos , Disfunção Erétil/diagnóstico , Ereção Peniana/efeitos da radiação , Neoplasias da Próstata/radioterapia , Lesões por Radiação/diagnóstico , Idoso , Braquiterapia/métodos , Relação Dose-Resposta à Radiação , Disfunção Erétil/etiologia , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Órgãos em Risco/efeitos da radiação , Paládio/administração & dosagem , Paládio/efeitos adversos , Medidas de Resultados Relatados pelo Paciente , Prognóstico , Estudos Prospectivos , Próstata/patologia , Próstata/efeitos da radiação , Neoplasias da Próstata/patologia , Lesões por Radiação/etiologia , Radioisótopos/administração & dosagem , Radioisótopos/efeitos adversos , Análise Espaço-Temporal , Fatores de Tempo
5.
Int Braz J Urol ; 45(6): 1204-1208, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31808409

RESUMO

PURPOSE: This study aims to assess the association between CHA2DS2-VASc score and erectile dysfunction in patients who were admitted to cardiology outpatient clinics. MATERIALS AND METHODS: One hundred and two male patients who were admitted to the cardiology outpatient clinic were included to the study. Erectile dysfunction was evaluated in the urology outpatient clinic in the same hospital and scored using Turkish Version of The International Index of Erectile Function. CHA2DS2-VASc score was calculated for every patient using the current associated guidelines. RESULTS: There was a negative correlation between The International Index of Erectile Function score and CHA2DS2-VASc score, age, hypertension, heart failure, diabetes mellitus, stroke respectively. Smoking and dislipidemia were not correlated with The International Index of Erectile Function score (p>0.05). CONCLUSION: CHA2DS2-VASc score can be used to detect Erectile dysfunction in patients who are admitted to the cardiology outpatient clinics.


Assuntos
Disfunção Erétil/diagnóstico , Disfunção Erétil/fisiopatologia , Medição de Risco/métodos , Adulto , Fatores Etários , Idoso , Antropometria , Estudos Transversais , Diabetes Mellitus/fisiopatologia , Insuficiência Cardíaca/fisiopatologia , Humanos , Hipertensão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Valores de Referência , Reprodutibilidade dos Testes , Fatores de Risco , Estatísticas não Paramétricas , Acidente Vascular Cerebral/fisiopatologia
6.
PLoS One ; 14(11): e0225179, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31714923

RESUMO

BACKGROUND: Stenoses of internal pudendal arteries (IPAs) appear to be related to erectile dysfunction (ED). Nevertheless, the correlation between the severity of ED and stenosis of the IPAs is not well established. OBJECTIVES: To evaluate angiographic findings of IPAs in patients with suspected coronary artery disease (CAD) and to assess the correlation between the severity of ED and IPA stenosis. MATERIALS AND METHODS: Ninety-one patients who were scheduled for cardiac angiogram (CAG) because of suspected CAD participated. ED was assessed using the International Index of Erectile Function (IIEF) questionnaire. Erectile function (EF) domain scoring was used to assess the severity of ED: severe (EF score = 1-10); moderate (11-16); mild-moderate (17-21); mild (22-25); and no ED (26-30). Angiography was performed in bilateral common, internal iliac, and IPAs and the location and extent of stenoses were measured. We divided patients according to those with maximum stenosis of less than 50% (Group I) and those with more than 50% (Group II), regardless of direction. RESULTS: We diagnosed 88 patients (88/91, 96.70%) with ED. There was no correlation between increasing age and severity of ED (r = - 0.063, p = 0.555). There were 72 patients in Group I and 19 in Group II. In Group I, 62 patients were diagnosed with ED even though there was no stenosis. There was no significant correlation between the severity of ED and the extent of stenosis in IPAs (r = -0.118, p = 0.265). CONCLUSIONS: There was no significant correlation between the severity of ED and the extent of stenosis of IPAs. We believe that this is because the progression of ED is induced by endothelial cell dysfunction, not by mechanical obstruction leading to blood flow reduction.


Assuntos
Arteriopatias Oclusivas/complicações , Doença da Artéria Coronariana/complicações , Disfunção Erétil/diagnóstico , Disfunção Erétil/etiologia , Idoso , Angiografia , Arteriopatias Oclusivas/diagnóstico , Comorbidade , Constrição Patológica , Doença da Artéria Coronariana/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença
7.
Am J Physiol Regul Integr Comp Physiol ; 317(5): R673-R683, 2019 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-31483153

RESUMO

In men with a spinal cord injury (SCI), erectile function, ejaculation, and fertility are severely impaired. The present study utilized a telemetric pressure transducer implanted into the corpus cavernosum of the penis to examine sexual function during awake mating behavior in a rat contusion model with a range of Infinite Horizon Impactor forces distributed between 150 and 215 kdyn. The mating behavior paradigm included examination of the counts, average pressure, and average duration for mounts, intromissions, and ejaculations. Male Wistar rats were mated with receptive females in 30-min sessions preinjury (sexual acclimation) and once per week for 6 wk beginning after a 2-wk recovery period post-SCI. All SCI animals had significant deficits in sexual function in the parameters measured. These deficiencies were more prevalent in a subset having less than 20% white matter sparing, likely a reflection of the extent of bilateral spino-bulbo-spinal sexual circuitry disruption at the lesion epicenter. The resulting discoordination of the autonomic and somatic reflex control of erection and ejaculation recorded using telemetry devices in an awake, behaving animal model provides an effective means of gauging sexual function deficits after SCI and could have utility for quantifying recovery after a therapeutic intervention.


Assuntos
Sistema Nervoso Autônomo/fisiopatologia , Disfunção Erétil/diagnóstico , Ereção Peniana , Pênis/inervação , Comportamento Sexual Animal , Traumatismos da Medula Espinal/complicações , Telemetria , Animais , Doença Crônica , Modelos Animais de Doenças , Disfunção Erétil/etiologia , Disfunção Erétil/fisiopatologia , Masculino , Pressão , Ratos Wistar , Traumatismos da Medula Espinal/fisiopatologia , Telemetria/instrumentação , Fatores de Tempo , Transdutores de Pressão
8.
Andrologia ; 51(10): e13374, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31347716

RESUMO

Red cell distribution width (RDW), one of the biomarkers used to measure vascular ageing, is known to correspond with cardiovascular diseases. As coronary artery disease and erectile dysfunction (ED) are both caused by the same shared pathophysiology, in this study, we compared the RDW values of men diagnosed with ED and those of healthy controls. Ninety-nine patients who were diagnosed with ED were included in the study. The control group consists of 100 men who presented to our outpatient clinic. Patients' fasting blood glucose, triglyceride, total cholesterol and LDL cholesterol levels were significantly higher in men diagnosed with ED. While the mean RDW value was 13.49 ± 1.52 in men with ED, it was 12.91 ± 1.13 in the control group. When RDW values were compared between the two groups, the RDW values of men with ED were found to be statistically significantly higher. Multivariate analyses showed that only the patients' body mass index, fasting blood sugar, triglyceride (TG), low-density lipoprotein cholesterol, high-density lipoprotein cholesterol levels (HDL-C), TG/HDL-C ratio and RDW levels' relationship with ED was statistically significant. Although some studies have shown that RDW may be related to some diseases such as cardiovascular diseases and cancer, this appears to be the first study demonstrating a relationship between RDW and ED. RDW can be utilised as a predictor for the determination of the presence and monitoring of the severity of ED.


Assuntos
Doença da Artéria Coronariana/complicações , Disfunção Erétil/diagnóstico , Índices de Eritrócitos , Adulto , Biomarcadores , Estudos de Casos e Controles , Doença da Artéria Coronariana/sangue , Disfunção Erétil/sangue , Disfunção Erétil/etiologia , Estudos de Viabilidade , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Prospectivos , Índice de Gravidade de Doença
9.
Andrologia ; 51(9): e13365, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31273827

RESUMO

The aim of this study was to evaluate the relationship between penile colour doppler ultrasonography (PCDUS) and complete blood count parameters in patients with erectile dysfunction (ED). The data of the patients who applied to our outpatient clinic with ED (IIEF-5 score <22 or IIEF-EF score <26) between January 2007 and May 2017 were retrospectively analysed. The patients who had available PCDUS results and complete blood count (CBC) values were included in the study. Patients were divided into two groups having normal (n = 530 [68.9%]) or abnormal (n = 240 [31.1%]) PCDUS findings (group 1 versus group 2 respectively). Subsequently, group 2 was divided into three subgroups according to presence of arterial insufficiency (group 2a; n = 85 [11%]), venous insufficiency (group 2b; n = 140 [18.2%]) and both of arterial and venous insufficiency (group 2c; n = 15 [1.9%]), and the four groups were compared in terms of CBC parameters. There was no statistically significant difference between the 4 groups, and between the patients with normal and abnormal PCDUS findings in terms of CBC values. CBC values were not associated with PCDUS findings in patients with ED.


Assuntos
Disfunção Erétil/diagnóstico , Ereção Peniana/fisiologia , Pênis/diagnóstico por imagem , Ultrassonografia Doppler em Cores , Adulto , Idoso , Contagem de Células Sanguíneas , Disfunção Erétil/sangue , Disfunção Erétil/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Pênis/irrigação sanguínea , Pênis/fisiopatologia , Estudos Retrospectivos , Fatores de Risco
10.
Rheumatol Int ; 39(9): 1527-1535, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31278432

RESUMO

Previous studies investigating the risk of erectile dysfunction (ED) among patients with gout have produced inconsistent evidence. Therefore, the aim of this meta-analysis was to investigate the relationship between gout and the risk of ED. The Embase, Medline, Scopus, Web of Science and Cochrane Library databases were searched for all studies assessing the risk of ED in patients with gout. Relative risks (RR) and corresponding 95% confidence intervals (CI) were adopted to estimate the association between gout and the risk of ED. Sensitivity analyses were applied to evaluate the robustness of results. Overall, 355,761 participants were included from 8 studies (3 cross-sectional and 5 cohort studies). Of these, 85,067 were patients with gout. Synthesis results showed patients with gout had a 1.2-fold higher risk of ED than individual without gout (RR 1.20, 95% CI 1.10-1.31, P < 0.001). The results of sensitivity analysis are consistent with the trend of synthesis results. The present meta-analysis revealed that the risk of ED in patients with gout was dramatically increased when compared with the general population, which suggests that clinicians should assess erectile function when treating an individual who suffers from gout.


Assuntos
Disfunção Erétil/epidemiologia , Gota/epidemiologia , Ereção Peniana , Adolescente , Adulto , Idoso , Disfunção Erétil/diagnóstico , Disfunção Erétil/fisiopatologia , Gota/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Medição de Risco , Fatores de Risco , Adulto Jovem
11.
BMC Res Notes ; 12(1): 376, 2019 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-31262359

RESUMO

OBJECTIVE: Drugs for managing mental disorders can cause adverse drug reactions (ADRs) that have negative impacts on patients yet, in Malawi, epidemiological data on the drug-related problems are limited. This study assessed the prevalence and severity of ADRs in out-patients at Zomba Mental Hospital. RESULTS: Twenty-six of forty patients (65.0%) were taking haloperidol and 14 (35.0%) chlorpromazine. The commonest diagnosis was schizophrenia (n = 23, 57.5%) followed by epileptic psychosis (n = 4, 10.0%) and general psychosis (n = 4, 10.0%) with one of psychotic depression and one psychosis secondary to general medical condition. Comorbidities were also found with epilepsy being the commonest (n = 4, 10.0%). All patients reported at least one ADR of varying severity (mild, moderate and severe). Polydipsia was the most prevalent (24, 60.0%) followed by weight gain (20, 50.0%), spasm (15, 37.5%) and xerostomia (15, 37.5%). Some ADRs were gender specific and these included impotence (6/27, 29.6%) for males and menstrual changes (3/14, 21.4%) for females. Severe ADRs were more common in the older aged group (> 35 years 8.3% vs 7.1%), in males (11.1% vs 0.0%) and on chlorpromazine (14.3% vs 3.8%). Patients taking chlorpromazine and haloperidol are at risk of experiencing a wide range of ADRs with varying degrees of severity.


Assuntos
Antipsicóticos/efeitos adversos , Clorpromazina/efeitos adversos , Disfunção Erétil/diagnóstico , Haloperidol/efeitos adversos , Distúrbios Menstruais/diagnóstico , Polidipsia/diagnóstico , Espasmo/diagnóstico , Xerostomia/diagnóstico , Adolescente , Adulto , Antipsicóticos/administração & dosagem , Clorpromazina/administração & dosagem , Estudos Transversais , Disfunção Erétil/etiologia , Disfunção Erétil/fisiopatologia , Feminino , Haloperidol/administração & dosagem , Hospitais Psiquiátricos , Humanos , Malaui , Masculino , Distúrbios Menstruais/etiologia , Distúrbios Menstruais/fisiopatologia , Pessoa de Meia-Idade , Pacientes Ambulatoriais , Polidipsia/etiologia , Polidipsia/fisiopatologia , Transtornos Psicóticos/tratamento farmacológico , Transtornos Psicóticos/fisiopatologia , Esquizofrenia/tratamento farmacológico , Esquizofrenia/fisiopatologia , Convulsões/tratamento farmacológico , Convulsões/fisiopatologia , Espasmo/etiologia , Espasmo/fisiopatologia , Ganho de Peso/efeitos dos fármacos , Xerostomia/etiologia , Xerostomia/fisiopatologia
12.
Andrologia ; 51(9): e13345, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31317572

RESUMO

The goal of this study was to investigate the association between serum oestradiol levels and clinically significant erectile dysfunction in a cohort of men presenting for andrological evaluation. Retrospective review was conducted of patients that presented to a urologist with practice in andrology over an 18-month period. Patients completed the Male Sexual Health Questionnaire and had serum total testosterone and oestradiol measurements prior to 10:30 a.m. via immunoassay. t Tests, chi-square tests and multivariate logistic regression were used to compare clinical characteristics between those with adequate erectile function (erection scale score > 2) vs. clinically significant erectile dysfunction (erection scale score ≤ 2). Among 256 patients, average age was 49 years (SD 15), average serum oestradiol was 22.3 pg/ml (SD 10.6), and average serum total testosterone was 465.9 pg/ml (SD 206.3). On multivariate logistic regression, serum oestradiol was associated with clinically significant erectile dysfunction (OR 1.52 per SD increase, 95% CI 1.11-2.09, p = 0.009) when controlling for serum total testosterone, age, body mass index and smoking status. These results warrant future studies on the utility of measuring serum oestradiol in patients with erectile dysfunction and the use of aromatase inhibitors in patients with erectile dysfunction and elevated serum oestradiol.


Assuntos
Disfunção Erétil/diagnóstico , Estradiol/sangue , Adulto , Idoso , Biomarcadores/sangue , Disfunção Erétil/sangue , Disfunção Erétil/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Ereção Peniana/fisiologia , Estudos Retrospectivos , Inquéritos e Questionários/estatística & dados numéricos , Testosterona/sangue
13.
Andrologia ; 51(9): e13347, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31231838

RESUMO

To examine the relation between NLR (neutrophil-lymphocyte ratio) and PLR (platelet-lymphocyte ratio) rates and the severity of ED (erectile dysfunction) and the effect of tadalafil 5 mg/day on these, a total of 143 patients were retrospectively evaluated. Sixty-three patients with ED who came for follow-up examinations in the 1st month of the treatment were included as the study group, and 80 men who were not diagnosed with ED were as the control group. The age and Charlson Comorbidity Indexes (CCI) of the study and control groups were compared with the IIEF 5, NLR and PLR values before and after the treatment. The mean age and median CCI were higher in the severe ED group (p < 0.05). The mean NLR and PLR values were lower in the control group (p < 0.001). In the study group, the NLR and PLR values decreased with the increase in the IIEF 5 scores (p < 0.001). The ROC curve was significant for the NLR and PLR scores (AUC = 0.779, [95% CI: 0.698-0.860]; AUC = 0.754, [95% CI: 0.670-0.838] p < 0.001). Although more prospective and randomized studies are needed, the systemic inflammation decreases and the clinical symptoms improve in patients who use tadalafil 5 mg/day.


Assuntos
Plaquetas , Disfunção Erétil/tratamento farmacológico , Linfócitos , Neutrófilos , Tadalafila/administração & dosagem , Adulto , Contagem de Células Sanguíneas , Estudos de Casos e Controles , Relação Dose-Resposta a Droga , Disfunção Erétil/sangue , Disfunção Erétil/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Ereção Peniana/efeitos dos fármacos , Estudos Retrospectivos , Índice de Gravidade de Doença , Resultado do Tratamento
14.
Physiol Res ; 68(4): 623-631, 2019 08 29.
Artigo em Inglês | MEDLINE | ID: mdl-31177798

RESUMO

Erectile dysfunction (ED) and diabetes mellitus (DM) share common pathophysiological risk factors including endothelial dysfunction which together with hyperglycemia contribute to the increased oxidative/glycooxidative stress. A reduced NO concentration is insufficient for relaxation processes in the penis. Chronic inflammation and endoglin are involved in the regulation of endothelial function. Adiponectin from the adipose tissue has anti-inflammatory effects. Our study aimed to investigate the relation between erectile function in patients with and without DM and the oxidative stress, hormone adiponectin, and endothelial dysfunction marker endoglin. Men (n=32) with ED evaluated by the International Index of Erectile function (IIEF-5) questionnaire (17 without DM (NDM); 15 with type 2 diabetes mellitus (DM)) and 31 controls were included. Advanced glycation end products (AGEs), 8-isoprostanes (8-isoP), protein carbonyls, antioxidant capacity, adiponectin and endoglin were determined in the blood. DM patients compared to NDM patients and controls, had increased levels of glucose, C-reactive protein, triacylglycerols, 8-isoP, AGEs, endoglin and BMI. IIEF-5 score, NO and adiponectin levels were decreased. We are the first to find out that endoglin shows a negative correlation with erectile function in NDM, but not in DM patients. Endoglin can be considered as endothelial dysfunction marker in nondiabetic men suffering from ED.


Assuntos
Adiponectina/sangue , Diabetes Mellitus Tipo 2/sangue , Endoglina/sangue , Disfunção Erétil/sangue , Estresse Oxidativo/fisiologia , Adulto , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/epidemiologia , Disfunção Erétil/diagnóstico , Disfunção Erétil/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade
15.
Med J Aust ; 210(10): 469-476, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31099420

RESUMO

Erectile dysfunction (ED) is a common male sexual dysfunction associated with a reduced quality of life for patients and their partners. ED is associated with increasing age, depression, obesity, lack of exercise, diabetes mellitus, hypertension, dyslipidaemia, cardiovascular disease and lower urinary tract symptoms related to benign prostatic hyperplasia. The evaluation of men with ED requires a full medical and personally and culturally sensitive sexual history, a focused clinical examination, fasting glucose levels, a fasting lipid profile and, in select cases, a total testosterone level and a prostate-specific antigen test. Treatment of ED requires lifestyle modification, reduction of comorbid vascular risk factors, and treatment of organic or psychosexual dysfunction with either pharmacotherapy alone or in combination with psychosexual therapy. Between 60% and 65% of men with ED, including those with hypertension, diabetes mellitus, spinal cord injury and other comorbid medical conditions, can successfully complete intercourse in response to the phosphodiesterase type 5 inhibitors (PDE5i) sildenafil, tadalafil, vardenafil and avanafil. Patient-administered intracorporal injection therapy using vasodilator drugs such as alprostadil is an effective treatment and is useful in men who fail to respond to oral pharmacological agents. Surgical treatment of ED with multicomponent inflatable penile implants is associated with high satisfaction rates. Penile arterial revascularisation and venous ligation surgery are associated with relatively poor outcome results in men with penile atherosclerotic disease or corporal veno-occlusive dysfunction.


Assuntos
Disfunção Erétil/diagnóstico , Disfunção Erétil/terapia , Qualidade de Vida , Humanos , Masculino , Pessoa de Meia-Idade , Inibidores de Fosfodiesterase/uso terapêutico , Comportamento Sexual/psicologia , Vasodilatadores/uso terapêutico
16.
Urologia ; 86(3): 148-151, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30983532

RESUMO

The aim of this study is to assess the erectile function of patients before and after transrectal ultrasound prostate biopsy comparatively in order to determine the appropriate time to evaluate erectile function before radical prostatectomy. A total of 44 patients underwent transrectal ultrasound biopsy. We used the International Index of Erectile Function-5 questionnaire to assess all the patients. In total, 44 volunteered patients were included in this study. All patients were evaluated with the International Index of Erectile Function-5 questionnaire before the biopsy and at 4 weeks after the transrectal ultrasound biopsy. A total of 50% of patients were potent before the biopsy was done. A month after the biopsies, erectile dysfunction was reported by 29 of 44 patients (66%) as mild in 10 (22.7%), as mild-moderate in 14 (31.8%), as moderate in 4 (9.1%), and severe in 1 (2.3%). The differences were statistically significant in the first month of the biopsy (p < 0.05). The effect of prostate biopsy upon the erectile function is non-negligible. However, this situation is temporary and transient. Therefore, it is recommended that the International Index of Erectile Function-5 questionnaire is to be administered prior to prostate biopsy rather than before surgical treatment.


Assuntos
Disfunção Erétil/diagnóstico , Disfunção Erétil/etiologia , Cuidados Pré-Operatórios/métodos , Prostatectomia , Adulto , Idoso , Humanos , Biópsia Guiada por Imagem/efeitos adversos , Masculino , Pessoa de Meia-Idade , Próstata/patologia , Prostatectomia/métodos , Neoplasias da Próstata/patologia , Neoplasias da Próstata/cirurgia , Autorrelato , Ultrassonografia de Intervenção
17.
Andrologia ; 51(6): e13282, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30938454

RESUMO

Studies show that erectile dysfunction (ED) is associated with obesity, and it has been shown that the possibility of developing sexual dysfunction in obese men is 30% higher compared to those with normal weight. Obesity is measured using various methods, for example waist circumference (WC) measurement or body mass index (BMI), but recently, visceral adiposity index (VAI) has also been utilised to better assess obesity and metabolic syndrome. In our study, the potential link between VAI and ED was investigated. The data of 176 patients who presented to the urology outpatient clinic with erection complaints were retrospectively screened. A control group was also established with 122 men without complaints of erectile dysfunction. The erectile functions of all participants were determined using the International Erectile Function Index-5 (IIEF-5) scoring. In addition, their serum fasting blood glucose, total testosterone (TT), triglyceride (TG), low-density lipoprotein (LDL) cholesterol and high-density lipoprotein (HDL) cholesterol levels were measured. The physical examination comprised the measurement of WC, height and weight, and BMI. The mean age of the participants was 58.7 ± 8.4 for the ED group and 57.1 ± 7.5 for the control group. The mean VAI was statistically significantly higher in the ED group (5.32 ± 2.77) compared to the control group (4.11 ± 1.93) (p < 0.001). Since VAI contains both physical and metabolic parameters, our findings suggest that it discloses the effects of WC, BMI, HDL and TG more clearly. VAI is considered useful for the assessment of the effect of obesity on ED patients.


Assuntos
Adiposidade/fisiologia , Disfunção Erétil/diagnóstico , Obesidade/complicações , Ereção Peniana/fisiologia , Idoso , Índice de Massa Corporal , Disfunção Erétil/etiologia , Disfunção Erétil/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Circunferência da Cintura
18.
Fortschr Neurol Psychiatr ; 87(4): 225-233, 2019 Apr.
Artigo em Alemão | MEDLINE | ID: mdl-30999379

RESUMO

Die S1-Leitlinie "Diagnostik und Therapie der erektilen Dysfunktion" (AWMF-Registernummer 030 / 112) steht in einer vollständig überarbeiteten Neufassung zur Verfügung. Erektile Dysfunktion ist definiert als die fortwährende Unfähigkeit, eine penile Erektion, die für einen befriedigenden Geschlechtsverkehr ausreicht, zu erreichen oder aufrechtzuerhalten. Betroffen sind Millionen Bundesbürger: Bei Männern mit regelmäßiger sexueller Aktivität nimmt die erektile Dysfunktion von 2,3 Prozent in der dritten Lebensdekade auf 53,4 Prozent in der siebten Lebensdekade zu. Die Leitlinie gibt dezidierte Empfehlungen zur adäquaten Diagnose und zur Therapie der erektilen Dysfunktion, die seit der Einführung der Phosphodiesterase-5-(PDE-5-)Hemmer häufig unkritisch erfolgt.


Assuntos
Disfunção Erétil/diagnóstico , Disfunção Erétil/terapia , Humanos , Masculino , Guias de Prática Clínica como Assunto
19.
Prim Care ; 46(2): 249-255, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31030826

RESUMO

Erectile dysfunction is a common condition. Many men do not self-report erectile dysfunction symptoms; thus, physicians must ask about sexual health and function to elicit concerns. Although the impact of untreated erectile dysfunction on quality of life should prompt physicians to ask about symptoms, so should the presence of cardiac and metabolic disease. Diagnosis of erectile dysfunction is made in the primary care office, and patients may be treated with oral, intraurethral, or intracavernosal medications; vacuum devices; or penile prosthesis. Treatment should be guided by patient preference with a goal of improving quality of life and mitigating chronic disease risk.


Assuntos
Disfunção Erétil/terapia , Inibidores da Fosfodiesterase 5/uso terapêutico , Administração Oral , Complicações do Diabetes , Disfunção Erétil/diagnóstico , Disfunção Erétil/etiologia , Disfunção Erétil/fisiopatologia , Cardiopatias/complicações , Humanos , Masculino , Fatores de Risco , Vasodilatadores/uso terapêutico
20.
Dig Liver Dis ; 51(6): 850-855, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31031175

RESUMO

INTRODUCTION: Erectile dysfunction (ED) is common in patients with chronic diseases. It is evaluated using the International Index of Erectile Function (IIEF5) questionnaire. The relationship between ED and cirrhosis is complex. The aims of our study were (1) to assess the prevalence of ED in cirrhosis and (2) to evaluate factors associated with ED, with a special focus on minimal hepatic encephalopathy (MHE). METHODS: We performed a prospective, observational study. Patients with cirrhosis were invited to complete the IIEF5 questionnaire. The exclusion criteria were clinical hepatic encephalopathy (HE) and dementia. MHE was evaluated by the psychometric hepatic encephalopathy test score (PHES) and the critical flicker frequency (CFF). RESULTS: Between April 2016 and April 2017, 87 patients were included (age: 55 [51-57] years, Child-Pugh score: 8 [7-9], MELD score: 13 [11-16]. Minimal HE was diagnosed in 33% of the patients according to the PHES and in 44% of the patients according to the CFF. ED was diagnosed in 74/87 patients (85%) when compared to 12.5% in healthy controls (p < 0.001). In a multivariate analysis, the independent factors associated with ED were age, Child-Pugh and MELD scores. Significant correlations were identified between the IIEF5 and each component of the PHES. CONCLUSION: ED should be systematically screened in cirrhotics, especially in patients with MHE.


Assuntos
Disfunção Erétil/diagnóstico , Encefalopatia Hepática/complicações , Cirrose Hepática/complicações , Disfunção Erétil/etiologia , Fusão Flicker , Encefalopatia Hepática/patologia , Humanos , Cirrose Hepática/patologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Prevalência , Estudos Prospectivos , Índice de Gravidade de Doença
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA