Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 7.028
Filtrar
1.
Zhonghua Nan Ke Xue ; 26(1): 48-53, 2020 Jan.
Artigo em Chinês | MEDLINE | ID: mdl-33345477

RESUMO

Objective: To investigate the impact of two different ureteral stents on the quality of life and erectile function of young and middle-aged men after ureteral laser lithotripsy. METHODS: A total of 118 male patients aged 22-45 years underwent ureteral laser lithotripsy followed by indwelling of the traditional double-J stent (the DJS group, n = 60) or Polaris loop stent (the PLS group, n = 58). We obtained the general information, intra- and post-operative clinical data, and scores on QOL, IPSS, Visual Analogue Scale (VAS) and IIEF, and compared them between the two groups of patients. RESULTS: There were no statistically significant differences in the body mass index, height, stone diameter, hydronephrosis degree, operation time, intra-operative adverse events, or post-operative stenting time between the two groups of patients. The PLS outperformed the DJS group in such clinical indexes as inflammation markers, lower urinary tract symptoms (LUTS), backache at urination, and QOL, IPSS and VAS scores during stenting at 4 weeks after operation(P < 0.05). The IIEF scores of the PLS and DJS groups were 8.44 ± 2.10 vs 12.50 ± 1.78 (P = 0.003) at 2 weeks, 8.65 ± 1.90 vs 13.42 ± 1.88 (P = 0.002) at 4 weeks, and 13.57 ± 1.01 vs 17.38 ± 2.47 (P = 0.003) at 6 weeks after operation, with no statistically significant difference between the two groups at 8 weeks. CONCLUSIONS: Ureteral stenting affects the quality of life and erectile function of young and middle-aged male patients after ureteral laser lithotripsy. The Polaris loop stent affects less the quality of life and erectile function of the patients than the traditional double-J stent during postoperative stenting.


Assuntos
Disfunção Erétil , Litotripsia a Laser , Qualidade de Vida , Stents , Adulto , Disfunção Erétil/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Stents/classificação , Ureteroscopia , Adulto Jovem
2.
Med Sci Monit ; 26: e927491, 2020 Dec 20.
Artigo em Inglês | MEDLINE | ID: mdl-33341820

RESUMO

BACKGROUND We explored the effect of asthma on erectile dysfunction (ED) and the effects of the expression of related proteins. MATERIAL AND METHODS We used a bioinformatics database to predict the targets and pathways associated with asthma and ED. The rat model of asthma was caused by an ovalbumin solution. The number of erections in 30 min was observed by injecting apomorphine into the neck at a dose of 100 µg/kg. Rats with no erection were regarded as the model group (group B), and the previous random 6 normal rats were regarded as the control group (group A). We used hematoxylin and eosin (HE) to compare the tissue structure of the cavernous body of the penis. Real-time quantitative polymerase chain reaction (RT-qPCR) and western blotting were used to determine the expression levels of insulin (INS), interleukin 6 (IL6), albumin (ALB), tumor necrosis factor (TNF), and vascular endothelial growth factor A (VEGFA) at both the protein and messenger ribonucleic acid (mRNA) levels. RESULTS HE staining results show that compared with group A, the blood sinus distribution of the cavernous body in group B was disordered, and the density of endothelial cells and smooth muscle cells decreased significantly. Western blotting and RT-qPCR showed that the levels of IL6, TNF, and VEGFA protein and mRNA in group B were significantly higher (P<0.05) than those in group A. The levels of INS and ALB were not significantly different between the 2 groups. CONCLUSIONS On the basis of the results, we found that asthma caused pathological changes in the penises of rats and led to reduced erectile function via changes in the expression of IL6, TNF, and VEGFA proteins.


Assuntos
Asma , Disfunção Erétil , Interleucina-6/metabolismo , Pênis , Fator de Necrose Tumoral alfa/metabolismo , Fatores de Crescimento do Endotélio Vascular/metabolismo , Animais , Asma/metabolismo , Asma/fisiopatologia , Bioensaio , Biologia Computacional/métodos , Modelos Animais de Doenças , Disfunção Erétil/etiologia , Disfunção Erétil/metabolismo , Masculino , Pênis/metabolismo , Pênis/fisiopatologia , Ratos
3.
Urologiia ; (6): 38-43, 2020 Dec.
Artigo em Russo | MEDLINE | ID: mdl-33377677

RESUMO

AIM: To study the efficacy and safety of using sildenafil in patients with erectile dysfunction (ED) and concomitant cardiovascular diseases (CVD) who underwent transurethral resection of the prostate (TURP). MATERIAL AND METHODS: A total of 59 patients (age from 50 to 75 years) with a diagnosis of benign prostatic hyperplasia (BPH), requiring surgical treatment due to inefficiency of drug therapy, I-PSS score more than 20 points), who were sexually active, but had erectile dysfunction (IIEF score < 21), coronary heart disease (NYHA class I) and stage 1-2 hypertension with stable blood pressure. All patients underwent bipolar TURP. From the first day after the TURP, therapy was prescribed as following: tamsulosin 0.4 mg once a day for 90 days, ciprofloxacin 500 mg twice a day for 10 days. In addition, the patients received treatment for comorbidities. In the main group (n=30), men additionally received sildenafil (EFFEX Sildenafil Evalar) 50 mg daily for 60 days, starting from the 30th day postoperatively. We have chosen this drug from an economic standpoint. RESULTS: At baseline, all patients in both groups had hemodynamic and microcirculatory disorders in the prostate, which got worse in the early postoperative period. During the long-term follow-up, hemodynamic and microcirculatory impairments decreased. This effect was more pronounced in patients who received sildenafil. In addition, patients had an improvement in sexual function. During follow-up, there was no adverse effects of sildenafil on hemodynamic parameters (blood pressure, heart rate). CONCLUSION: Our results allow to recommend sildenafil in order to restore sexual function postoperatively in patients with BPH, including those with concomitant cardiovascular disorders.


Assuntos
Disfunção Erétil , Hiperplasia Prostática , Ressecção Transuretral da Próstata , Disfunção Erétil/tratamento farmacológico , Disfunção Erétil/etiologia , Humanos , Masculino , Microcirculação , Hiperplasia Prostática/complicações , Hiperplasia Prostática/cirurgia , Citrato de Sildenafila/uso terapêutico , Resultado do Tratamento
4.
Urologiia ; (6): 70-74, 2020 Dec.
Artigo em Russo | MEDLINE | ID: mdl-33377682

RESUMO

INTRODUCTION: Erectile dysfunction (ED) is a condition characterized by the inability to achieve or maintain an erection sufficient for sexual intercourse. The prevalence of ED ranges from 6% to 64% depending on age. Obesity is one of the factors leading to ED, which is widespread in the world. Men with obesity are 30% more likely to develop ED compared with men with normal body weight. AIM: The aim was to identify morphological changes in the cavernous tissue of the penis of patients with obesity using the biological model of laboratory rats as an example. MATERIALS AND METHODS: In vivo modeling of diet-induced obesity was performed. A total of 22 laboratory sexually mature white rats weighing 140-160 g were included in the study. The animals were divided into two groups, the control group (n=10) and experimental group, which included rats with diet-induced obesity (n=12). After 12 weeks, the experiment was completed. All rats underwent: 1) calculation of the Lee index (body mass index in rats); 2) determination of blood glucose level; 3) determination of the level of total cholesterol and triglycerides in the blood; 4) sampling of the penis with fixation in 10% formalin; histological sections 6-8 m thick were stained with hematoxylin and eosin, and frozen sections were prepared with subsequent staining with Sudan 3 to identify adipose cells. RESULTS: In the experimental group, alimentary obesity developed. There were no differences in glucose and total cholesterol levels between two groups. However, a significant difference was found in the serum triglycerides level (1.24+/-0.05 mmol/L in the control group vs. 1.6+/-0.1 mmol/L in the experimental group). In the control group, the average number of adipocytes was 10+/-5 per sample; in the experimental group, their number increased by 3 times (p<0.01). In obese rats, there was an increase not only in the number of adipose cells, but also in their area compared with the control group (17.7+/-7.5 m and 12.9+/-5.3 m, respectively, p<0.01). CONCLUSION: In rats with alimentary obesity, deposition of adipose tissue is observed not only in the visceral and paratesticular regions, but also in the cavernous tissue of the penis, which can negatively affect erectile function.


Assuntos
Disfunção Erétil , Pênis , Tecido Adiposo , Animais , Disfunção Erétil/etiologia , Humanos , Masculino , Obesidade/complicações , Ereção Peniana , Ratos
5.
Postgrad Med ; 132(sup4): 4-8, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33156731

RESUMO

Peyronie's Disease is an incurable condition of the tunica albuginea of the penis associated with scarring, plaque formation, and penile deformity on erection. It is often associated with erectile dysfunction. Recent data have supported a familial and genetic predisposition to this chronic condition. The etiology of Peyronie's Disease is unknown, but is likely associated with multiple micro traumas to the erect penis in men who are susceptible to the scarring typical of Peyronie's Disease. The treatment of Peyronie's Disease has improved over the past decade as a result of animal studies and the approval of new medications. In the acute phase of the condition, phosphodiesterase type 5 inhibitors have been shown to have some benefit and are supported by animal studies demonstrating reduced fibrosis of the penis in animal models of Peyronie's Disease. In the stable phase of the disease, newer injectable agents have shown great promise. Collagenase clostridium histolyticum is approved for the treatment of Peyronie's plaques by direct injection into the scarred tissue with data showing satisfactory safety and efficacy. Surgical procedures for penile straightening have been refined with improved outcomes in the past decade. For those men with erectile dysfunction and Peyronie's Disease, penile implants can restore erectile function and form. As a result of the new understanding of the risk factors for Peyronie's Disease and recent advances in treatment options, the algorithm for the treatment of Peyronie's Disease has improved outcomes for patients and their partners.


Assuntos
Disfunção Erétil/etiologia , Disfunção Erétil/terapia , Induração Peniana/complicações , Aconselhamento , Humanos , Masculino , Saúde do Homem , Colagenase Microbiana/uso terapêutico , Preferência do Paciente , Induração Peniana/patologia , Prótese de Pênis , Inibidores da Fosfodiesterase 5/uso terapêutico
6.
Wiad Lek ; 73(9 cz. 2): 2049-2055, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33148858

RESUMO

OBJECTIVE: 75% of men with coronary artery disease confirmed by coronarography have erectile dysfunction in history, while 75% of patients with a vascular etiology of ED have significant stenoses in penile arterial vascularization. Patients with coronary artery disease have shown a relationship between the range of the lesions in the coronary vessels and erectile dysfunction intensity. This paper aims at attempting to systematize the knowledge of the benefits and drawbacks of nonsurgical endovascular treatment methods for erectile dysfunction with confirmed vascular causes. It analyzes seven studies which assess the results of erectile dysfunction treatment with percutaneous angioplasty. It also mentions the limitations of the cited works and formulates relevant conclusions. CONCLUSION: Conclusions: The analysis shows that endovascular procedures in erection-related arteries are safe in a specially selected group of men. It is necessary to conduct further studies to define an appropriate group of patients who have a chance of benefiting optimally from the endovascular treatment of erectile dysfunction in a long-term follow-up.


Assuntos
Procedimentos Endovasculares , Disfunção Erétil , Impotência Vasculogênica , Disfunção Erétil/etiologia , Disfunção Erétil/terapia , Humanos , Impotência Vasculogênica/etiologia , Impotência Vasculogênica/terapia , Masculino , Ereção Peniana , Pênis
7.
Urologiia ; (5): 51-53, 2020 11.
Artigo em Russo | MEDLINE | ID: mdl-33185347

RESUMO

INTRODUCTION: Radical prostatectomy (RP) remains the main treatment method of localized prostate cancer. Satisfactory functional results after RP are essential for both urologist and patient. Preservation of sexual function, particularly orgasmic function (OF) after RP is of the utmost importance today for patients and their sexual partners. MATERIALS AND METHODS: An analysis of 3- and 6-months functional results of 91 patients who underwent RP for prostate cancer is presented in this study. The influence of surgical approach, nerve-sparing surgery (NSS) and other factors for OF recovery was evaluated. RESULTS: OF recovered in 53,8% and 56% patients 3 and 6 months postoperatively, respectively. Positive influence of younger age and NSS on OF recovery was found. CONCLUSION: OF recovered in more than half of patients after RP. The young age, NSS were found to be predictors of RP recovery. Further research is required to determine the more relevant factors for OF recovery after RP.


Assuntos
Disfunção Erétil , Neoplasias da Próstata , Disfunção Erétil/etiologia , Humanos , Masculino , Orgasmo , Prostatectomia , Neoplasias da Próstata/cirurgia , Recuperação de Função Fisiológica
8.
Sci Rep ; 10(1): 17595, 2020 10 19.
Artigo em Inglês | MEDLINE | ID: mdl-33077779

RESUMO

Various neurovascular bundle-sparing techniques have been introduced to maximize recovery of erectile function after robot-assisted radical prostatectomy (RARP). The clipless intrafascial neurovascular bundle-sparing technique aims to preserve periprostatic structures and neurovascular bundles as much as possible by avoiding clipping of the vascular pedicles. This study reports 1-year functional and oncologic outcomes and postoperative complications in 105 patients with intact preoperative erectile function who underwent a modified clipless intrafascial neurovascular bundle-sparing RARP. Intact erectile function was defined as score ≥ 21 on the Sexual Health Inventory for Men questionnaire or ability to have sexual intercourse. Median follow-up was 26.5 months (IQR 15.25-48). Postoperative erectile function recovery rates were 71.4%, 81.9%, 88.6%, 92.4%, and 94.3% at 1, 3, 6, 9, and 12 months, respectively. The rate of positive surgical margins was 16.2% overall and 11.8% in patients with stage pT2 disease. The biochemical recurrence rate was 6.7% overall. The modified clipless intrafascial neurovascular bundle-sparing technique is safe and feasible and can achieve excellent recovery of erectile function after RARP. Further large-scale prospective comparative studies are warranted.


Assuntos
Disfunção Erétil/etiologia , Próstata/cirurgia , Prostatectomia/métodos , Neoplasias da Próstata/cirurgia , Procedimentos Cirúrgicos Robóticos/métodos , Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Ereção Peniana/fisiologia , Complicações Pós-Operatórias/etiologia , Próstata/patologia , Prostatectomia/efeitos adversos , Neoplasias da Próstata/patologia , Recuperação de Função Fisiológica , Procedimentos Cirúrgicos Robóticos/efeitos adversos , Resultado do Tratamento
9.
BMJ ; 371: m3503, 2020 10 07.
Artigo em Inglês | MEDLINE | ID: mdl-33028540

RESUMO

OBJECTIVE: To assess treatment related changes in quality of life up to 15 years after diagnosis of localised prostate cancer. DESIGN: Population based, prospective cohort study with follow-up over 15 years. SETTING: New South Wales, Australia. PARTICIPANTS: 1642 men with localised prostate cancer, aged less than 70, and 786 controls randomly recruited from the New South Wales electoral roll into the New South Wales Prostate Cancer Care and Outcomes Study (PCOS). MAIN OUTCOME MEASURES: General health and disease specific quality of life were self-reported at seven time points over a 15 year period, using the 12-item Short Form Health Survey scale, University of California, Los Angeles prostate cancer index, and expanded prostate cancer index composite short form (EPIC-26). Adjusted mean differences were calculated with controls as the comparison group. Clinical significance of adjusted mean differences was assessed by the minimally important difference, defined as one third of the standard deviation (SD) from the baseline score. RESULTS: At 15 years, all treatment groups reported high levels of erectile dysfunction, depending on treatment (62.3% (active surveillance/watchful waiting, n=33/53) to 83.0% (non-nerve sparing radical prostatectomy, n=117/141)) compared with controls (42.7% (n=44/103)). Men who had external beam radiation therapy or high dose rate brachytherapy or androgen deprivation therapy as primary treatment reported more bowel problems. Self-reported urinary incontinence was particularly prevalent and persistent for men who underwent surgery, and an increase in urinary bother was reported in the group receiving androgen deprivation therapy from 10 to 15 years (year 10: adjusted mean difference -5.3, 95% confidence interval -10.8 to 0.2; year 15: -15.9; -25.1 to -6.7). CONCLUSIONS: Patients receiving initial active treatment for localised prostate cancer had generally worse long term self-reported quality of life than men without a diagnosis of prostate cancer. Men treated with radical prostatectomy faired especially badly, particularly in relation to long term sexual outcomes. Clinicians and patients should consider these long term quality of life outcomes when making treatment decisions.


Assuntos
Antagonistas de Androgênios , Braquiterapia , Efeitos Adversos de Longa Duração , Prostatectomia , Neoplasias da Próstata , Qualidade de Vida , Idoso , Antagonistas de Androgênios/efeitos adversos , Antagonistas de Androgênios/uso terapêutico , Austrália/epidemiologia , Braquiterapia/efeitos adversos , Braquiterapia/métodos , Estudos de Coortes , Disfunção Erétil/epidemiologia , Disfunção Erétil/etiologia , Humanos , Efeitos Adversos de Longa Duração/epidemiologia , Efeitos Adversos de Longa Duração/etiologia , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Estudos Prospectivos , Prostatectomia/efeitos adversos , Prostatectomia/métodos , Neoplasias da Próstata/epidemiologia , Neoplasias da Próstata/patologia , Neoplasias da Próstata/psicologia , Neoplasias da Próstata/terapia , Risco Ajustado , Incontinência Urinária/epidemiologia , Incontinência Urinária/etiologia
10.
J Surg Oncol ; 122(8): 1647-1654, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32959406

RESUMO

BACKGROUND AND OBJECTIVES: This prospective study aimed to identify long-term changes in sexual function of men with rectal cancer from point of diagnosis to 24 months postoperatively. METHODS: Male patients undergoing laparoscopic rectal cancer surgery were prospectively enrolled. International Index of Erectile Function (IIEF) Questionnaire scores were collected at diagnosis; first follow-up; and 6, 12, and 24 months postoperatively. Missing values were managed via multiple imputations using the propensity score method. Paired t tests were applied to examine changes in IIEF scores over time. RESULTS: This study analyzed 115 patients. For erectile function, there were no significant changes in scores from the point of diagnosis to first treatment (9.4 vs. 9.8 as mean scores; p = .227). Scores deteriorated postoperatively and recovered until 12 months post-surgery, but did not improve significantly from 12 months to 24 months post-surgery (8.7 vs. 8.2 as mean scores; p = .440). This pattern of change was observed in all other domains: orgasmic function, sexual desire, orgasmic satisfaction, and overall satisfaction. CONCLUSIONS: Sexual function was not influenced by a rectal cancer diagnosis. Sexual function deteriorated following surgery and recovered until 12 months post-surgery; however, it did not significantly improve from 12 months to 24 months postoperatively.


Assuntos
Disfunção Erétil/fisiopatologia , Laparoscopia/efeitos adversos , Complicações Pós-Operatórias/fisiopatologia , Qualidade de Vida , Neoplasias Retais/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Disfunção Erétil/etiologia , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Prognóstico , Estudos Prospectivos , Neoplasias Retais/diagnóstico , Inquéritos e Questionários , Adulto Jovem
11.
Rev. int. androl. (Internet) ; 18(3): 91-95, jul.-sept. 2020. tab, graf
Artigo em Inglês | IBECS | ID: ibc-193599

RESUMO

PURPOSE: In this study, we retrospectively reviewed the penile color Doppler ultrasound (PCDU) scans of the patients who had admitted to our clinic with erectile dysfunction and aimed to evaluate the contribution of penile Doppler scan results to the clinical decisions. MATERIAL-METHOD: The data of patients admitted to our outpatient clinic with complaints of erectile dysfunction (IIEF-5 score<22 or IIEF-EF score<26) between January 2005 and January 2018 were retrospectively evaluated. Patients whose testosterone level is lower than 280ng/ml or who had undergone radical prostatectomy were excluded from the analysis. RESULTS: Three thousand ninety patients were included in the study. The mean age of our patients was 55.05±13.05 years. In total, 2139 (69%) patients had normal PCDU findings, 351 (11%) patients had arterial insufficiency, 531 (17%) patients had venous insufficiency, and 69 (2%) patients had arterial insufficiency with concurrent venous leakage. When the patients were divided into 2 groups ≤40 years (Group 1) old and >40 years (Group 2) old; normal PCDU findings were found in 432 patients (84%) of the Group 1 patients and normal PCDU findings in 1707 (66%) patients of the Group 2 patients (p < 0.0001). There were arterial insufficiency findings in 24 (4.7%) and 327 (12.7%) patients of the Group 1 and 2, respectively (p = 0.002). CONCLUSION: The etiology is psychogenic in the majority of patients who present with ED complaints to the urology clinic. With age, the prevalence of psychogenic ED is decreasing but still more than organic


OBJETIVO: En este estudio, revisamos retrospectivamente las ecografías Doppler a color del pene (PCDU) de los pacientes que ingresaron en nuestra clínica con disfunción erectile, el objetivo era evaluar la contribución de los resultados de la ecografía Doppler peneana a las decisiones clínicas. MATERIAL Y MÉTODO: Los datos de los pacientes ingresados en nuestra clínica ambulatoria con quejas de disfunción eréctil (puntuación IIEF-5<22 o puntuación IIEF-EF<26) entre enero de 2005 y enero de 2018 se evaluaron retrospectivamente. Los pacientes cuyo nivel de testosterona fuera inferior a 280ng/ml o a los cuales se les hubiera realizado una prostatectomía radical se excluyeron del análisis. RESULTADOS: En el estudio se incluyó a 3.090 pacientes. La media de edad de nuestros pacientes fue de 55,05±13,05 años. En total, en 2.139 pacientes (69%) hubo hallazgos normales en la PCDU; en 351 (11%) se observó insuficiencia arterial; en 531 (17%) insuficiencia venosa y en 69 (2%) insuficiencia arterial con reflujo venoso simultáneo. Cuando los pacientes se dividieron en 2 grupos, ≤40 años (grupo 1) y >40 años (grupo 2), se encontraron hallazgos normales de la PCDU en 432 pacientes (84%) de los pacientes del grupo 1 y hallazgos normales de PCDU en 1.707 pacientes (66%) del grupo 2 (p < 0,0001). Hubo hallazgos de insuficiencia arterial en 24 (4,7%) y 327 (12,7%) pacientes de los grupos 1 y 2, respectivamente (p = 0,002). CONCLUSIÓN: La etiología es psicógena en la mayoría de los pacientes que presentan quejas de en la clínica de urología. Con la edad, la prevalencia de la DE psicógena va disminuyendo, pero todavía es más psicógena que orgánica


Assuntos
Humanos , Masculino , Adulto , Pessoa de Meia-Idade , Disfunção Erétil/diagnóstico por imagem , Disfunção Erétil/psicologia , Disfunção Erétil/etiologia , Estudos Retrospectivos , Ultrassonografia Doppler , Pênis/diagnóstico por imagem , Insuficiência Venosa/fisiopatologia , Fatores Etários
14.
Medicine (Baltimore) ; 99(36): e22161, 2020 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-32899103

RESUMO

BACKGROUND: Diabetes mellitus with erectile dysfunction (DMED) is one of the most common causes of disability in diabetic population, and its pathogenesis is related to a variety of factors. Because its pathogenesis is complex and the existing treatment methods have limitations, DMED is difficult to treat in clinical. Recently, some studies have shown that α-lipoic acid (ALA) is associated with DMED, but there is no systematic review and meta-analysis on the relationship between ALA and DMED. METHODS: We will search each database from the built-in until July 2020. The English literature mainly searches Cochrane Library, PubMed, EMBASE, and Web of Science, while the Chinese literature comes from CNKI, CBM, VIP, and Wangfang database. Simultaneously we will retrieve clinical registration tests and grey literatures. This study only screen the clinical randomized controlled trials (RCTs) about ALA for DMED to assess its efficacy. The 2 researchers worked independently on literature selection, data extraction, and quality assessment. The dichotomous data is represented by relative risk (RR), and the continuous is expressed by mean difference (MD) or standard mean difference (SMD), eventually the data is synthesized using a fixed effect model (FEM) or a random effect model (REM) depending on whether or not heterogeneity exists. Erectile dysfunction (ED) will be diagnosed by the International Index of Erectile Function 5 (IIEF-5) score. Finally, meta-analysis was conducted by RevMan software version 5.3. RESULTS: This study will synthesize and provide high quality to evaluate the effectiveness of ALA supplementation for the treatment of DMED. CONCLUSION: This systematic review aims to provide new options for ALA supplementation treatment of DMED in terms of its efficacy and safety. PROSPERO REGISTRATION NUMBER: INPLASY202070130.


Assuntos
Complicações do Diabetes/patologia , Disfunção Erétil/tratamento farmacológico , Disfunção Erétil/etiologia , Ácido Tióctico/uso terapêutico , Humanos , Masculino , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de Pesquisa , Ácido Tióctico/administração & dosagem , Ácido Tióctico/efeitos adversos
16.
J Sex Med ; 17(9): 1687-1693, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32736945

RESUMO

OBJECTIVES: Here we examine the association between shift work sleep disorder (SWSD) and erectile dysfunction (ED) in shift workers. METHODS: Men presenting to a single andrology clinic between January 2014 and July 2017 completed validated questionnaires: International Index of Erectile Function (IIEF), Patient Health Questionnaire-9 (PHQ-9), and the nonvalidated SWSD Questionnaire. Men were also asked about shift work schedule, comorbidities, phosphodiesterase 5 (PDE5) inhibitor use, and testosterone use. Serum total testosterone values were determined for each visit. Linear regression was performed controlling for testosterone use, testosterone levels, PDE5 inhibitor use, age, and comorbidities to determine the effect of SWSD on ED as assessed using the IIEF. RESULTS: Of the 754 men completing questionnaires, 204 reported nonstandard shift work (begins before 7 am or after 6 pm, regularly extends out of that frame, or rotates frequently) and 48 were found to have SWSD using a screening questionnaire. Nonstandard shift work alone did not result in worse IIEF-EF scores (P = .31), but those who worked nonstandard shifts and had SWSD demonstrated IIEF-EF scores 2.8 points lower than men without SWSD (P < .01). When assessing for the type of shift work performed, men who worked night shifts had IIEF-EF scores 7.6 points lower than men who worked during the day or evening (P < .01). Testosterone use improved IIEF-EF scores for men with SWSD by 2.9 points, ameliorating the effect of SWSD on ED. However, baseline testosterone levels were not associated with worse erectile function in this cohort. CONCLUSION: Men with SWSD have worse erectile function, with men who work night shifts having even poorer erectile function. These findings suggest that circadian rhythm disturbance may significantly impact erectile function. While testosterone therapy may partly reverse the effects of SWSD, shift work is a potential risk factor for ED and should be assessed for as part of the evaluation of men with ED. Rodriguez KM, Kohn TP, Kohn JR, et al. Shift Work Sleep Disorder and Night Shift Work Significantly Impair Erectile Function. J Sex Med 2020;17:1687-1693.


Assuntos
Disfunção Erétil , Jornada de Trabalho em Turnos , Transtornos do Sono do Ritmo Circadiano , Disfunção Erétil/etiologia , Humanos , Masculino , Ereção Peniana , Jornada de Trabalho em Turnos/efeitos adversos , Testosterona
17.
J Med Life ; 13(2): 144-150, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32742505

RESUMO

Erectile dysfunction is a multifactorial disease; it has been demonstrated that endothelial dysfunction plays an essential role in the pathogenesis of this disease, and Vitamin D deficiency is considered to favor endothelial lesions. Our study, based on a group of 58 patients who have erectile dysfunction and a control group of 26 healthy subjects, tends to confirm that low levels of vitamin D could potentiate the severity of erectile dysfunction, promoting endothelial dysfunction. Statistical analysis using the Pearson's correlation criteria showed a robust and significant correlation between vitamin D levels and erectile dysfunction severity (ρ=0.752, p<0.000) according to the SHIM (Sexual Health Inventory For Men) questionnaire. Also, in patients with erectile dysfunction, there is a strong association between vitamin D and testosterone levels (ρ=0.728, p<0.000). At the same time, a negative correlation between vitamin D and BMI (ρ=-0.517, p<0.000); cholesterol (ρ=-0.560, p<0.001), and triglycerides(ρ=-0.529, p<0.005) was observed. Also, a moderate correlation between erectile dysfunction severity degree and testosterone levels (ρ=0.544) was also detected, and the same severity parameter of erectile dysfunction correlates negatively with cholesterol levels (ρ=-0.534). In its turn, the testosterone level correlates negatively with other biochemical indices: cholesterol (ρ=-0.694) and triglycerides (ρ=-0.670). Vitamin D level reduction, concomitantly with decreased testosterone and increased cholesterol, contributes to the development and maintenance of erectile dysfunction, more probably through endothelial mechanisms. The assessment of vitamin D values can be used as an independent marker in erectile dysfunction assessment. Thus, one of the diagnostic tests recommended for erectile dysfunction should be the determination of the vitamin D serum level.


Assuntos
Disfunção Erétil/sangue , Vitamina D/sangue , Adulto , Idoso , Biomarcadores/sangue , Disfunção Erétil/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto Jovem
18.
J Sex Med ; 17(7): 1280-1287, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32624131

RESUMO

BACKGROUND: High salt intake is a risk factor for hypertension, which can potentially lead to erectile dysfunction (ED); however, the underlying pathological mechanisms remain unclear. AIM: To investigate whether erectile function is directly impaired by high salt intake and whether selective inhibition of mineralocorticoid receptor (MR) could provide protection from ED. METHODS: 6-week-old male Dahl salt-sensitive rats were randomly divided into 3 groups: normal diet (0.3% NaCl; control, n = 8), high-salt diet (8% NaCl; HS, n = 8), and high-salt diet plus eplerenone (HS + EPL, n = 11). HS + EPL rats were orally administered daily doses of EPL (75 mg/kg) for 6 weeks; control and HS rats received purified water on the same schedule. OUTCOMES: At the end of the study period, erectile function was evaluated by measuring intracavernosal pressure and mean arterial pressure after cavernous nerve stimulation. Serum levels of asymmetric dimethylarginine and L-arginine were determined using ultraperformance liquid chromatography-tandem mass spectrometry. Quantitative PCR was used to assess the expression of MR, inflammation, and oxidative stress markers (nicotinamide adenine dinucleotide phosphate oxidase-1/4, p22phox, interleukin-6, and superoxide dismutase-1), and protein arginine N-methyltransferase-1. RESULTS: The intracavernosal pressure/mean arterial pressure ratio was significantly lower, whereas systolic blood pressure, MR expression, serum asymmetric dimethylarginine levels, oxidative stress, and levels of inflammatory biomarkers were significantly higher in HS rats than in control rats (P < .05). EPL administration significantly improved each of these parameters except systolic blood pressure and MR expression. No significant intergroup differences were observed for L-arginine and superoxide dismutase-1 levels. CLINICAL TRANSLATION: Our results provide a rationale for the need of salt restriction and the use of selective MR inhibitors in prophylaxis or treatment of ED in men consuming a high-salt diet. STRENGTHS & LIMITATIONS: We are the first to report that the adverse impact of high salt intake on erectile function is mediated via MR activation, independent of its effect on blood pressure. A major limitation of this study is that responses of salt-resistant rats were not studied. CONCLUSIONS: High salt intake directly impaired erectile function in Dahl salt-sensitive rats, whereas selective MR inhibition ameliorated this effect. Kishimoto T, Kataoka T, Yamamoto Y, et al. High Salt Intake Impairs Erectile Function in Salt-Sensitive Rats Through Mineralocorticoid Receptor Pathway Beyond Its Effect on Blood Pressure. J Sex Med 2020;17:1280-1287.


Assuntos
Disfunção Erétil , Hipertensão , Animais , Pressão Sanguínea , Disfunção Erétil/tratamento farmacológico , Disfunção Erétil/etiologia , Humanos , Hipertensão/induzido quimicamente , Hipertensão/tratamento farmacológico , Masculino , Ratos , Ratos Endogâmicos Dahl , Receptores de Mineralocorticoides , Cloreto de Sódio , Cloreto de Sódio na Dieta/efeitos adversos
19.
Acta Clin Croat ; 59(1): 173-176, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32724290

RESUMO

Endocrinopathies are relatively rare causes of erectile dysfunction. Cases of hyperprolactinemia and pituitary adenomas have been previously reported. We present a clinical case of a 27-year-old male with suspected infertility and recent symptoms of erectile dysfunction. Additional radiological and endocrinologic workup revealed underlying subependymoma, which was expanding in the sellar and suprasellar regions, causing pressure against the pituitary gland. The resulting endocrine disorder caused problems that were subjectively at first manifested mainly as erectile dysfunction. The case is an educative example pointing to the need of taking possible intracranial lesions in consideration when starting workup in a patient presenting with erectile dysfunction. It may be of broad clinical interest not only for endocrinologists but also for practitioners in various fields.


Assuntos
Disfunção Erétil , Glioma Subependimal , Hiperprolactinemia , Neoplasias Hipofisárias , Adulto , Encéfalo , Disfunção Erétil/etiologia , Glioma Subependimal/complicações , Glioma Subependimal/diagnóstico por imagem , Humanos , Masculino , Neoplasias Hipofisárias/complicações , Neoplasias Hipofisárias/diagnóstico por imagem
20.
BJU Int ; 126 Suppl 1: 12-17, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32542884

RESUMO

OBJECTIVE: To provide a clinical framework and key guideline statements to assist clinicians in the evidence-based management of Peyronie's disease (PD). METHODS: We conducted a review of the published literature relevant to PD management, with an emphasis on published clinical guidelines. References used in the text have been assessed according to their level of evidence, and guideline recommendations have been graded based on the Oxford Centre for Evidence-based Medicine Levels of Evidence. RESULTS: The management of PD involves taking a detailed penile and sexual history, with a focused penile examination to identify plaque and hourglass deformity, and digital photographs of the erect curved (deformed) penis. Penile colour Duplex ultrasonography evaluates tunical plaque and underlying cavernosal smooth muscle and blood flow variables. The current therapy for PD can be divided into two main groups, namely, medical therapy and penile reconstructive surgery, and the patient should be counselled on the benefits and risks of each treatment option. CONCLUSIONS: Peyronie's disease remains a clinical challenge and presents a considerable therapeutic dilemma as the current therapy addresses existing penile curvature only and is not very effective in preventing future penile fibrosis and/or reversing underlying erectile dysfunction.


Assuntos
Procedimentos Clínicos , Induração Peniana/terapia , Aconselhamento , Progressão da Doença , Disfunção Erétil/etiologia , Humanos , Masculino , Induração Peniana/complicações , Induração Peniana/diagnóstico , Induração Peniana/psicologia , Pênis/cirurgia , Guias de Prática Clínica como Assunto , Procedimentos Cirúrgicos Reconstrutivos , Fatores de Risco
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA