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1.
Medicine (Baltimore) ; 99(32): e21588, 2020 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-32769911

RESUMO

BACKGROUND: Erectile dysfunction is a common disease. It affects the quality of life of both husband and wife and its prevalence is higher in patients with overt cardiovascular disease or cardiovascular risk factors. In recent years, multiple studies confirm that nebivolol exerts protective effects on erectile function against the disruptive effects of cardiopulmonary bypass in patients undergoing coronary artery bypass grafting, but its quality and efficacy have not been systematically evaluated. Therefore, it is necessary to carry out a systematic review and meta-analysis to fully evaluate the efficacy and safety of nebivolol on erectile function in the cases with coronary artery bypass grafting. METHODS AND ANALYSIS: Chinese and English literature of nebivolol on erectile function in the cases with coronary artery bypass surgery published before August 31, 2020 will be comprehensive searched in PubMed, Cochrane Library, EMBASE, WANFANG, China National Knowledge Infrastructure, VIP Chinese Science and Technology Journal Database, Chinese biomedical document service system, and Clinicaltrials.gov. Only randomized controlled trials that meet the eligibility criteria will be included. Two researchers will independently complete literature screening, data extraction and assess the risk of bias, and the third investigator will handle disagreements. Our main evaluation includes 2 outcome indicators including the international index of erectile function 5 score and adverse events. RevMan 5.3 and Stata 14.0 will be used to conduct this systematic review. The preferred reporting items for systematic reviews and meta-analysis protocols (PRISMA-P) statement is followed in this protocol and the PRISMA statement will be followed in the completed systematic review. CONCLUSION AND DISSEMINATION: The efficacy and safety of nebivolol on erectile function in the cases with coronary artery bypass grafting will be evaluated. We will publish the results of this systematic review in peer-reviewed journals to provide new evidence to clinicians. ETHICS AND DISSEMINATION: Ethical approval is not required as the review is a secondary study based on published literature. The results will be published in a public issue journal to provide evidence-based medical evidence for urologists and andrologists to make better clinical decisions. REGISTRATION INFORMATION: INPLASY202060110.


Assuntos
Protocolos Clínicos , Ponte de Artéria Coronária/efeitos adversos , Disfunção Erétil/tratamento farmacológico , Nebivolol/uso terapêutico , Ponte de Artéria Coronária/métodos , Disfunção Erétil/fisiopatologia , Humanos , Masculino , Metanálise como Assunto , Nebivolol/normas , Revisões Sistemáticas como Assunto
2.
Vasc Health Risk Manag ; 16: 231-239, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32606719

RESUMO

Erectile dysfunction (ED) is defined as a man's consistent or recurrent inability to attain and/or maintain penile erection enough for successful vaginal intercourse. ED affects a large part of the population, increasing its incidence with age and comorbidities. It is estimated by the year 2025, 322 million men will suffer from ED. Incidence of ED has been related not only to chronic diseases such as diabetes mellitus, metabolic syndrome, hyperlipidemia, psychiatric diseases or urinary tract diseases, but also to hypertension and especially to antihypertensive treatments. This review summarizes current knowledge about the management of ED in hypertensive men and its role as cardiovascular disease predictor.


Assuntos
Anti-Hipertensivos/uso terapêutico , Pressão Sanguínea/efeitos dos fármacos , Disfunção Erétil/terapia , Hipertensão/tratamento farmacológico , Ereção Peniana/efeitos dos fármacos , Inibidores da Fosfodiesterase 5/uso terapêutico , Anti-Hipertensivos/efeitos adversos , Tomada de Decisão Clínica , Disfunção Erétil/diagnóstico , Disfunção Erétil/epidemiologia , Disfunção Erétil/fisiopatologia , Humanos , Hipertensão/diagnóstico , Hipertensão/epidemiologia , Hipertensão/fisiopatologia , Masculino , Inibidores da Fosfodiesterase 5/efeitos adversos , Fatores de Risco , Resultado do Tratamento
3.
Nat Commun ; 11(1): 2687, 2020 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-32483116

RESUMO

Injury of corpus cavernosa results in erectile dysfunction, but its treatment has been very difficult. Here we construct heparin-coated 3D-printed hydrogel scaffolds seeded with hypoxia inducible factor-1α (HIF-1α)-mutated muscle-derived stem cells (MDSCs) to develop bioengineered vascularized corpora. HIF-1α-mutated MDSCs significantly secrete various angiogenic factors in MDSCs regardless of hypoxia or normoxia. The biodegradable scaffolds, along with MDSCs, are implanted into corpus cavernosa defects in a rabbit model to show good histocompatibility with no immunological rejection, support vascularized tissue ingrowth, and promote neovascularisation to repair the defects. Evaluation of morphology, intracavernosal pressure, elasticity and shrinkage of repaired cavernous tissue prove that the bioengineered corpora scaffolds repair the defects and recover penile erectile and ejaculation function successfully. The function recovery restores the reproductive capability of the injured male rabbits. Our work demonstrates that the 3D-printed hydrogels with angiogenic cells hold great promise for penile reconstruction to restore reproductive capability of males.


Assuntos
Subunidade alfa do Fator 1 Induzível por Hipóxia/genética , Pênis/lesões , Transplante de Células-Tronco/métodos , Animais , Sobrevivência Celular , Modelos Animais de Doenças , Disfunção Erétil/diagnóstico por imagem , Disfunção Erétil/fisiopatologia , Disfunção Erétil/cirurgia , Feminino , Heparina , Humanos , Hidrogéis , Imagem por Ressonância Magnética , Masculino , Camundongos , Camundongos Nus , Proteínas Mutantes/genética , Neovascularização Fisiológica , Pênis/irrigação sanguínea , Pênis/fisiopatologia , Gravidez , Impressão Tridimensional , Coelhos , Tecidos Suporte , Transfecção
4.
Niger J Clin Pract ; 23(6): 870-878, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32525125

RESUMO

Background: This study aimed to identify the unmet sexual health needs of the patients with diabetes seen in a tertiary healthcare facility in Nigeria. Methods: Case-control study design and random sampling method were utilized to recruit type 2 diabetic cases from the University of Calabar Teaching Hospital (UCTH), Calabar, Nigeria. Female Sexual Function Index (FSFI) and International Index for Erectile Function (IIEF) were used to assess sexual function. Result: There were 330 subjects with the mean age of 54.9 years. Among females, the FSFI score was lower among cases compared with controls (18.8 vs. 23.1, P < 0.05). Except for sexual interest, mean scores for all other domains of sexual function were also lower among cases (P < 0.05). Among males, there was no significant difference in overall mean IIEF score comparing cases and controls (40.0 vs. 41.7, P > 0.05). However, mean scores for desire and satisfaction was lower among cases compared with controls (P < 0.05). Older age, unmarried status, presence and duration of hypertension were associated with sexual dysfunction among females. The use of supplements was associated with sexual dysfunction among males (P < 0.05). Conclusion: Sexual dysfunction is common among diabetics with variation in affected domains in both genders in the study setting. These unmet sexual health needs focus to be addressed.


Assuntos
Complicações do Diabetes/epidemiologia , Diabetes Mellitus/fisiopatologia , Disfunção Erétil/fisiopatologia , Ereção Peniana/fisiologia , Disfunções Sexuais Fisiológicas , Disfunções Sexuais Psicogênicas/epidemiologia , Sexualidade/fisiologia , Adulto , Idoso , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Satisfação Pessoal , Comportamento Sexual , Disfunções Sexuais Psicogênicas/etiologia
5.
Einstein (Sao Paulo) ; 18: eAO5070, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32321079

RESUMO

OBJECTIVE: To evaluate epidemiological aspects of priapism in patients with sickle cell disease, and these aspects impact on adult sexual function. METHODS: This was a cross-sectional study including individuals with sickle cell disease who were evaluated at a reference center for sickle cell. Participants completed a structured questionnaire about their sociodemographic characteristics and priapism events. Sexual function was assessed using validated two instruments, the Erection Hardness Score and one about the sex life satisfaction. RESULTS: Sixty-four individuals with median aged of 12 (7 to 28) years were interviewed. The prevalence of priapism was 35.9% (23/64). The earliest priapism episode occurred at 2 years of age and the latest at 42 years. The statistical projection was that 71.1% of individuals of the study would have at least one episode of priapism throughout life. Patients with episodes of priapism (10/23) had significantly worse erectile function Erection Hardness Score of 2 [1-3]; p=0.01 and were less satisfied with sexual life 3 [3-5]; p=0.02. CONCLUSION: Priapism is usually present in childhood, and severe episodes are associated with cavernous damage, impairment in the quality of the erection, and lower sexual satisfaction.


Assuntos
Anemia Falciforme/epidemiologia , Anemia Falciforme/fisiopatologia , Disfunção Erétil/epidemiologia , Disfunção Erétil/fisiopatologia , Priapismo/epidemiologia , Priapismo/fisiopatologia , Adolescente , Adulto , Fatores Etários , Brasil/epidemiologia , Criança , Estudos Transversais , Intervalo Livre de Doença , Humanos , Masculino , Ereção Peniana/fisiologia , Prevalência , Priapismo/etiologia , Qualidade de Vida , Estudos Retrospectivos , Estatísticas não Paramétricas , Inquéritos e Questionários , Adulto Jovem
6.
Rev Med Suisse ; 16(686): 531-538, 2020 Mar 18.
Artigo em Francês | MEDLINE | ID: mdl-32186798

RESUMO

Peyronie's disease (PD) is a relatively unknown cause of sexual dysfunction. Symptoms may include the appearance of an erectile deformity, pain in the penis and erectile dysfunction (ED). The etiology is most often unclear, and medical treatments are limited, although improvement is always possible. However, surgical treatment remains the only option when the disease has stabilized and in the event of significant erectile and sexual disability.


Assuntos
Induração Peniana/fisiopatologia , Disfunção Erétil/complicações , Disfunção Erétil/fisiopatologia , Humanos , Masculino , Ereção Peniana , Induração Peniana/complicações , Pênis/fisiopatologia
7.
Expert Rev Cardiovasc Ther ; 18(3): 155-164, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32192361

RESUMO

Introduction: A large body of evidence has clearly documented that erectile dysfunction (ED) represents not only a complication of cardiovascular (CV) diseases (CVD) but often an early sign of forthcoming CVD.Areas covered: All the available data from meta-analyses evaluating the association between ED and CV risk were collected and discussed. Similarly, all available meta-analyses investigating the significance of ED as a possible early marker for major adverse cardiovascular events (MACE) were analyzed. In addition, data originally obtained in a Florence cohort, dealing with a large series of patients seeking medical care for sexual dysfunction, will be also reported.Expert opinion: Available evidence indicates that ED represents a risk factor of CV mortality and morbidity. Not only conventional CV risk factors but also unconventional ones, derived from a perturbation of the relational and intrapsychic domains of ED, might play a possible role in CV risk stratification of ED subjects. Finally, penile doppler ultrasound can give important information on CV risk, especially in younger and low risk subjects. The presence of ED should become an opportunity - for the patient and for the physician - to screen for the presence of comorbidities improving not only sexual health but, more importantly, men's overall health.


Assuntos
Doenças Cardiovasculares/epidemiologia , Disfunção Erétil/fisiopatologia , Pênis/irrigação sanguínea , Biomarcadores , Doenças Cardiovasculares/diagnóstico , Sistema Cardiovascular/fisiopatologia , Humanos , Masculino , Metanálise como Assunto , Pênis/diagnóstico por imagem , Fatores de Risco
8.
J Med Vasc ; 45(1): 3-12, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32057324

RESUMO

The goal of this work was to demonstrate that Doppler ultrasound (DUS) after pharmacological stimulation of erection (PSE) can be used to evaluate the presence and intensity of a cavernovenous leak (CVL) suspected in erectile dysfunction (ED) patients. The study was built around 50 DUS-PSE exams of penile arteries and veins, which were carried out 3, 5, 10 and 20minutes after pharmacological stimulation. Measured parameters were end diastolic velocity of the cavernous arteries and mean velocity of the deep penile vein and/or penile superficial veins. A score from 0 to 3 was attributed to each according to the recorded velocities. A final score from 0 to 9 was established by adding the three values: patients quoting 0 and 1 were classified as "no leak" (n=8); from 2 to 9 (n=42) as "leaking". Penile computed tomography (CT-scan) under identical pharmacological stimulation identified the cavernovenous leak to be compared with the DUS-PSE results, which were valid in 47 cases (94%), with 97.6% sensitivity and 77.7% specificity. The kappa correlation coefficient for CT-scan diagnosis of suspected CVL was 0.7875 (P<0.001). In addition, we found that end diastolic velocity in the cavernous artery, considered up until now as the gold standard in cases of suspected CVL was insufficient (negative predictive value=47%). In addition to its well-known diagnostic value regarding ED of arterial origin, DUS-PSE is an excellent screening test for CVL, especially in young patients without vascular risk factors who are resistant to medical treatments. For those with well-established CVL, confirmation by CT-scan to discuss possible surgery should be the next step. Moreover, DUS-PSE is useful in postoperative monitoring.


Assuntos
Atropina/administração & dosagem , Dipiridamol/administração & dosagem , Disfunção Erétil/diagnóstico por imagem , Papaverina/administração & dosagem , Ereção Peniana , Pênis/irrigação sanguínea , Pênis/diagnóstico por imagem , Piperidinas/administração & dosagem , Piribedil/administração & dosagem , Ultrassonografia Doppler de Pulso , Ioimbina/administração & dosagem , Adulto , Idoso , Velocidade do Fluxo Sanguíneo , Angiografia por Tomografia Computadorizada , Combinação de Medicamentos , Disfunção Erétil/fisiopatologia , Disfunção Erétil/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Pênis/cirurgia , Valor Preditivo dos Testes , Recuperação de Função Fisiológica , Fluxo Sanguíneo Regional , Reprodutibilidade dos Testes , Estudos Retrospectivos , Resultado do Tratamento
9.
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
10.
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
11.
J Urol ; 203(1): 137-144, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31347951

RESUMO

PURPOSE: We compared early continence recovery after surgical treatment of prostate cancer with Retzius sparing robot-assisted radical prostatectomy and conventional robot-assisted radical prostatectomy. MATERIALS AND METHODS: Robot-assisted radical prostatectomy was done by a single surgeon in 1,863 cases between October 2005 and May 2018 using the conventional and the Retzius sparing technique in 1,150 and 713, respectively. To compare continence outcomes between the groups propensity score matching was performed using 9 preoperative variables, including age, body mass index, prostate specific antigen, biopsy Gleason Grade Group, clinical T stage, prostate volume on transrectal ultrasound, and the I-PSS (International Prostate Symptom Score), I-PSS quality of life score and International Index of Erectile Function-5 scores. Continence was assessed by the pad count every month postoperatively until month 6 and was converted to a binary outcome. RESULTS: After propensity score matching 609 cases per group were matched with no significant difference in all 9 variables. The Kaplan-Meier curve analysis revealed that Retzius sparing robot-assisted radical prostatectomy was associated with a significantly better continence recovery rate than conventional robot-assisted radical prostatectomy during the 6-month study period (p <0.001). CONCLUSIONS: Based on propensity score matching with multiple variables and a large case series, Retzius sparing robot-assisted radical prostatectomy can be a candidate for future robot-assisted radical prostatectomy. It achieves better early continence recovery, a short operative time and early recovery compared to conventional robot-assisted radical prostatectomy.


Assuntos
Complicações Pós-Operatórias/fisiopatologia , Prostatectomia/métodos , Neoplasias da Próstata/cirurgia , Procedimentos Cirúrgicos Robóticos/métodos , Incontinência Urinária/fisiopatologia , Idoso , Disfunção Erétil/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Pontuação de Propensão , Neoplasias da Próstata/patologia , Qualidade de Vida , Recuperação de Função Fisiológica
12.
Int Braz J Urol ; 45(6): 1196-1203, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31808408

RESUMO

AIMS: Radical prostatectomy (RP) can result in urinary incontinence (UI) and erectile dysfunction (ED), which negatively impact quality of life (QoL). This study aimed to evaluate the effects of a perioperative pelvic floor muscle training (PFMT) program versus usual care on early recovery of urinary continence and erectile function after RP. MATERIALS AND METHODS: Of 59 eligible men, 31 were randomly allocated into 2 groups: Group 1 (Control, N=15) received usual post-RP care; and Group 2 (Physical therapy, N=16) received two pre-RP physical therapist-guided PFMT sessions, including exercises and electromyographic biofeedback, and verbal and written instructions to continue PFMT until RP, which was then resumed after urethral catheter removal. The International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF) and the 5-item version of the International Index of Erectile Function (IIEF-5) questionnaire were used to evaluate UI and ED, respectively. RESULTS: Demographic characteristics were similar in both groups. Three months after RP, the UI rate was 72.7% and 70.0% in Groups 1 and 2, respectively (P >0.05). The severity and frequency of UI and its impact on QoL were evaluated by the ICIQ-Short Form, with scores of 6.9±6.26 in Group 1 and 7.0±5.12 in Group 2 (P >0.05). The IIEF-5 scores were similar in Groups 1 and 2 (5.73±7.43 vs. 6.70±6.68, respectively) (P >0.05). CONCLUSION: Our pre-RP protocol of two physical therapist-assisted sessions of PFMT plus instructions did not signifi cantly improve urinary continence or erectile function at 3 months after RP.


Assuntos
Disfunção Erétil/reabilitação , Exercícios de Alongamento Muscular/métodos , Diafragma da Pelve/fisiopatologia , Assistência Perioperatória/métodos , Prostatectomia/reabilitação , Incontinência Urinária/reabilitação , Adenocarcinoma/patologia , Adenocarcinoma/cirurgia , Idoso , Disfunção Erétil/etiologia , Disfunção Erétil/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Contração Muscular/fisiologia , Gradação de Tumores , Estadiamento de Neoplasias , Neurorretroalimentação , Estudos Prospectivos , Prostatectomia/efeitos adversos , Prostatectomia/métodos , Neoplasias da Próstata/patologia , Neoplasias da Próstata/cirurgia , Qualidade de Vida , Inquéritos e Questionários , Resultado do Tratamento , Incontinência Urinária/etiologia , Incontinência Urinária/fisiopatologia
13.
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
14.
Acta Cir Bras ; 34(8): e201900803, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31618403

RESUMO

PURPOSE: To evaluate changes in the quantity of elastic fibers in the corpora cavernosa of rats during the natural aging process, and to assess the degree of this change by determining volumetric density (Vv) at different ages via stereological analysis. METHODS: Forty-eight rats, raised under similar conditions, were subjected to the natural aging process and divided into four groups (G1 to G4), according to age at the time of penectomy (6, 9, 12, and 24 months, respectively). Histological sections of the middle segment of the penis were stained with Weigert's resorcin-fuchsin, and the volumetric density (Vv) of elastic fibers of the corpora cavernosa were determined via stereological analysis. RESULTS: There were no statistically significant differences in Vv among groups G1, G2, and G3. These three groups were therefore considered as a single group. The mean Vv of this group showed a statistically significant reduction compared to that of G4 (0.16 vs. 0.11, p<0.05). CONCLUSION: Natural aging in rats was responsible for a reduction in volumetric density of elastic fibers of the corpora cavernosa (approximately 30% decrease in Vv) during senescence.


Assuntos
Envelhecimento/fisiologia , Tecido Elástico/ultraestrutura , Células Endoteliais/fisiologia , Pênis/citologia , Envelhecimento/patologia , Animais , Colágeno/fisiologia , Colágeno/ultraestrutura , Tecido Elástico/patologia , Tecido Elástico/fisiologia , Disfunção Erétil/fisiopatologia , Masculino , Modelos Animais , Pênis/fisiologia , Ratos , Ratos Wistar
15.
BMC Res Notes ; 12(1): 696, 2019 Oct 25.
Artigo em Inglês | MEDLINE | ID: mdl-31653261

RESUMO

OBJECTIVE: This small scale cross-sectional study was done to identify the common systolic blood pressure pattern (dipping or non-dipping) among type 2 diabetic men with coexisting hypertension and erectile dysfunction(ED). A recent study in the same setting showed that prevalence of ED was high among diabetic men and co-existing hypertension was identified as an independent risk factor. There was a postulation about an association between ED and non-dipping nocturnal blood pressure pattern. So ambulatory blood pressure measurements (ABPM) was obtained for participants to test this prediction. Data was analysed using SPSS 25 Version. RESULTS: Among 29 participants who underwent ABPM, 21 showed non-dipping pattern of nocturnal systolic blood pressure (72.4%; CI 54.3-86.3). Mean SBP of participants was 125.55 +_14.1 and Mean DBP was 81.5 + _12.82. There was no statistical difference observed in mean SBP and DBP between patients with dipping nocturnal SBP and non-dipping pattern (P > 0.05). Variability of SBP was high among the participants (Mean SD-11.96 +/_2.74) and DBP also showed relatively high variability (SD-9.28 +/_2.9). Mean dipping percentage of the SBP during sleep was 5.54 +/_6.66. A significant difference in heart rate (HR) between patients with non-dipping and dipping pattern was noted (P-0.034).


Assuntos
Pressão Sanguínea/fisiologia , Ritmo Circadiano/fisiologia , Diabetes Mellitus Tipo 2/fisiopatologia , Disfunção Erétil/fisiopatologia , Hipertensão/fisiopatologia , Monitorização Ambulatorial da Pressão Arterial/métodos , Monitorização Ambulatorial da Pressão Arterial/estatística & dados numéricos , Comorbidade , Estudos Transversais , Diabetes Mellitus Tipo 2/epidemiologia , Disfunção Erétil/epidemiologia , Frequência Cardíaca/fisiologia , Humanos , Hipertensão/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Sri Lanka/epidemiologia , Fatores de Tempo
17.
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
18.
PLoS One ; 14(9): e0222803, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31539416

RESUMO

The natural product icariin inhibits human phosphodiesterase-5 (PDE5) and represents a unique pharmacophore for treating erectile dysfunction, pulmonary hypertension, and other diseases. In this study, we explore the available icariin-derived chemical scaffolds through medicinal chemistry to develop novel icariin PDE5 inhibitors with improved potency and specificity. We synthesized six novel semi-synthetic icariin analogs as well as three naturally occurring icariin analogs, and characterized the structure-activity relationship in the context of human PDE5 inhibition using in vitro enzyme inhibition and kinetics assays and molecular modeling. Mammalian-cell-based assays and in vitro enzyme inhibition assays against human PDE6C further helped to identify the most potent and selective icariin analogs. Our results reveal the synergistic contribution of functional groups at the C3 and C7 positions of the icariin backbone towards PDE5 inhibition. Whereas a hydrophobic and flexible alkanol group at the C7 position is sufficient to enhance icariin analog potency, combining this group with a hydrophilic sugar group at the C3 position leads to further enhancement of potency and promotes specificity towards PDE5 versus PDE6C. In particular, compounds 3 and 7 exhibit Ki values of 0.036 ± 0.005 µM and 0.036 ± 0.007 µM towards PDE5 respectively, which are approaching those of commercial PDE5 inhibitors, and can effectively reduce GMP levels in cultured human BJ-hTERT cells. This study identifies novel icariin analogs as potent and selective PDE5 inhibitors poised to become lead compounds for further pharmaceutical development.


Assuntos
GMP Cíclico/metabolismo , Nucleotídeo Cíclico Fosfodiesterase do Tipo 5/metabolismo , Flavonoides/farmacologia , Inibidores da Fosfodiesterase 5/farmacologia , Animais , Biocatálise/efeitos dos fármacos , Linhagem Celular , Linhagem Celular Tumoral , GMP Cíclico/química , Nucleotídeo Cíclico Fosfodiesterase do Tipo 5/química , Disfunção Erétil/tratamento farmacológico , Disfunção Erétil/metabolismo , Disfunção Erétil/fisiopatologia , Flavonoides/síntese química , Flavonoides/química , Humanos , Hipertensão Pulmonar/tratamento farmacológico , Hipertensão Pulmonar/metabolismo , Hipertensão Pulmonar/fisiopatologia , Masculino , Modelos Químicos , Estrutura Molecular , Inibidores da Fosfodiesterase 5/síntese química , Inibidores da Fosfodiesterase 5/química , Relação Estrutura-Atividade
19.
Eur J Pharmacol ; 863: 172675, 2019 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-31542487

RESUMO

The aim was to evaluate and characterize H2S-induced relaxation of human corpus cavernosum (HCC) and penile resistance arteries (HPRA) from patients with erectile dysfunction (ED). HCC and HPRA were obtained from men with ED at the time of penile prosthesis insertion. H2S-mediated relaxations were evaluated by exposing these tissues to the stable analogue, NaHS, and to the precursor of H2S, L-cysteine (CYS). The effects of NaHS and CYS were also evaluated on cGMP accumulation in HCC and on acetylcholine- and sildenafil-mediated relaxations in HCC and HPRA. NaHS consistently relaxed HPRA and HCC and more potently than human prostate and bladder. NaHS-induced relaxations in HCC and HPRA were unaffected by the ATP-sensitive K+-channel blocker, glibenclamide or the NO synthase inhibitor, L-NAME, slightly reduced by the Ca2+-activated K+-channel blocker, tetraethylammonium, and markedly inhibited by the soluble guanylyl cyclase inhibitor, ODQ. NaHS caused a cGMP increase in HCC that was inhibited by ODQ. CYS produced relaxations of HCC and HPRA that were sensitive to ODQ and to inhibition of the H2S synthesizing enzymes, cystathionine γ-lyase (CSE) and cystathionine ß-synthase (CBS). CYS also increased cGMP in HCC. In contrast to NaHS, CYS-induced relaxations were prevented by endothelium removal in HPRA. Only in HPRA, treatment with CYS (30 µM) potentiated acetylcholine- and sildenafil-induced relaxations. This effect was prevented by CSE/CBS inhibition and by removing the endothelium. Exogenous and endogenous H2S relaxes HCC and HPRA from ED patients through cGMP accumulation and potentiates vasodilatory capacity of PDE5 inhibition, supporting the therapeutic potential of modulating H2S pathway.


Assuntos
Cisteína/metabolismo , Disfunção Erétil/fisiopatologia , Sulfeto de Hidrogênio/metabolismo , Relaxamento Muscular/efeitos dos fármacos , Pênis/efeitos dos fármacos , Inibidores da Fosfodiesterase 5/farmacologia , Vasodilatação/efeitos dos fármacos , Artérias/efeitos dos fármacos , Artérias/fisiopatologia , GMP Cíclico/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , Pênis/irrigação sanguínea , Pênis/fisiopatologia , Citrato de Sildenafila/farmacologia
20.
Trans Am Clin Climatol Assoc ; 130: 51-59, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31516164

RESUMO

The field of sexual medicine, in reference to the science of the sexual response and the clinical management of sexual dysfunctions, has evolved remarkably in the last 25 years. Erection biology has been central in driving this progress and is measured considerably by the discovery, study, and clinical translation of a simple gaseous molecule, nitric oxide, which is operative in the penis. Nitric oxide functions extraordinarily as a neurotransmitter and molecular signal transducer. It is now well understood to be the principal molecular mediator of penile erection and to be a critical element involved in dysregulatory mechanisms of erection disorders ranging from erectile dysfunction to priapism. It is most familiarly associated with the scientific development of oral medications for treating erectile dysfunction, which has modernized the clinical management of this condition.


Assuntos
Disfunção Erétil/tratamento farmacológico , Óxido Nítrico/fisiologia , Ereção Peniana/fisiologia , Disfunção Erétil/metabolismo , Disfunção Erétil/fisiopatologia , Humanos , Masculino , Óxido Nítrico/metabolismo , Óxido Nítrico Sintase Tipo I/metabolismo , Óxido Nítrico Sintase Tipo III/metabolismo , Inibidores da Fosfodiesterase 5/uso terapêutico , Citrato de Sildenafila/uso terapêutico
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