PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Erectile Dysfunction”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 451 records · Page 25Linked to original sources
PubMed2001

['Leiden Impotence Screening Test'(LIST) in men with erectile dysfunction as a pre-selective method prior to psychophysiological diagnostic tests].

OBJECTIVE: To compare, in men with erectile dysfunction, the diagnosis obtained with the 'Leiden impotence questionnaire' (LIQ)--which differentiates between psychogenic and organic erectile dysfunction--with the clinical diagnosis based on psychophysiological diagnostic screening (PDS). DESIGN: Exploratory, comparative, and prospective. METHOD: The LIQ-questionnaire was administered to 320 consecutive patients with erectile dysfunction who underwent PDS (i.e. visual sexual stimulation and penile vibration) in the Department of Endocrinology and Reproduction, Erasmus University Medical Centre, Rotterdam, the Netherlands. The clinical diagnosis was based on PDS and later, retrospectively, compared to the LIQ-based diagnosis (only the first six of the 11 LIQ-questions were answered by all patients). RESULTS: The clinical diagnosis, psychogenic or somatic, corresponded well with the LIQ-diagnosis. Following PDS an organic aetiology was assumed in 30% of the patients; compared to 33% according to the LIQ. For a psychogenic aetiology the figures were 70% and 67% respectively. Overall there was a 74% correspondence between PDS-diagnosis and the LIQ-diagnosis. Age was a significant factor: younger men (< 40 years) had the highest LIQ-score (compared to men aged 40-60 and > 60 years) and the strongest penile responses. This is indicative of a more frequent psychogenic aetiology of the erectile dysfunction in younger men. CONCLUSION: Elaborate psychophysiological diagnostic screening is not necessarily the first diagnostic choice in men with erectile dysfunction; one may start by applying the LIQ. A high LIQ-score (5-7) virtually excludes a somatic aetiology. A low LIQ-score (0-2) necessitates further psychosomatic diagnostic screening, preferably with PDS.

Adult↗
PubMed2006

Subclinical erectile dysfunction: proposal for a novel taxonomic category in sexual medicine.

The definition of erectile dysfunction currently used and accepted worldwide does not encompass all possible changes to male erection. Partial, temporary, or episodic absence of erection is not considered as true erectile dysfunction. This leads to a lack of diagnosis and therapy and perhaps even the risk of the subsequent development of overt impotence. The lack of an evidence-based diagnosis of such a condition may be due to the widespread, pernicious self-prescription of erection drugs, obtained from the illegal market. To define the pathological condition of men experiencing a lack of erection who are unaffected by erectile dysfunction, we propose herein a new taxonomic category, based on new sexological criteria. In addition, we suggest research into biochemical markers to define this condition, which we have named subclinical erectile dysfunction.

Erectile Dysfunction↗
PubMed2006

Impact of erectile dysfunction on confidence, self-esteem and relationship satisfaction after 9 months of sildenafil citrate treatment.

PURPOSE: The first double-blind, placebo controlled trial in the United States of the Self-Esteem And Relationship questionnaire revealed that treatment with sildenafil citrate improves erectile function and measures of quality of life in men with erectile dysfunction. We investigated long-term improvement, and correlations between improved erectile function and confidence, self-esteem and sexual relationship satisfaction in men with erectile dysfunction. MATERIALS AND METHODS: This was a 36-week open label extension of the double-blind, placebo controlled trial. The blind was not broken. Patients were 18 years or older with clinically diagnosed erectile dysfunction. Erectile function was assessed using the International Index of Erectile Function. Self-esteem, confidence and relationship satisfaction were assessed using the Self-Esteem And Relationship questionnaire. Correlations were determined using Pearson's product moment coefficients. RESULTS: A total of 204 participants were enrolled in the open label extension, including 108 on placebo and 96 on sildenafil. In men who received placebo in the double-blind, placebo controlled phase mean erectile function scores and self-esteem, confidence and relationship satisfaction scores were increased significantly at week 36 of the open label extension (p < 0.0001). Men who received sildenafil in the double-blind, placebo controlled phase maintained high scores in the open label extension. Correlations between improved erectile function, and self-esteem, confidence and relationship satisfaction were strong and positive (p < 0.0001). CONCLUSIONS: Open label extension sildenafil after double-blind, placebo controlled placebo significantly improved erectile function, self-esteem, confidence and relationship satisfaction. Following an initial 12 weeks of double-blind, placebo controlled sildenafil therapy for erectile dysfunction improvements were sustained an additional 9 months. Positive correlations between erectile function, and self-esteem, confidence and relationship satisfaction suggest that improved erectile quality can improve long-term psychosocial quality of life.

Adult↗
PubMed2006

Erection hardness: a unifying factor for defining response in the treatment of erectile dysfunction.

The extensive sildenafil citrate erectile dysfunction (ED) database of double-blind, placebo-controlled clinical trials was examined to determine the relation between erection hardness graded on the Erectile Hardness Grading Scale (EHGS) and (1) erectile function (EF), as assessed by the EF domain of the International Index of Erectile Function (IIEF); (2) frequency of erections hard enough for penetration, as assessed by IIEF Q2; and (3) the percentage of successful sexual intercourse attempts according to patient event logs. Pooled data from 6549 men with ED provided strong proof and improved characterization of the response to sildenafil. Almost half of men with ED and a baseline IIEF EF domain score classified as "severe ED" (< or = 10) shifted to a score classified as "no ED" (> or = 26). Sildenafil recipients showed greater mean improvement from baseline to end point in IIEF Q2 scores versus placebo, regardless of baseline ED severity, and a higher mean percentage of successful sexual intercourse attempts occurred during the last 4 weeks of treatment versus placebo (5.4-fold vs 2.0-fold increase from baseline). At end point, 95% of men who scored "no ED" on the IIEF EF domain and 92% of men who reported "almost always/always" achieving an erection hard enough for penetration (IIEF Q2) had graded their erections hard (rigid) enough for penetration (grade 3) or completely hard and fully rigid (grade 4) during the last 4 weeks of treatment, suggesting that the IIEF EF domain and IIEF Q2 may be good surrogate end points for erection hardness. Furthermore, during the last 4 weeks of treatment, the percentage of grade 3 and/or 4 erections correlated positively with the percentage of successful sexual intercourse attempts. Hence, hard erections may be considered a unifying factor that defines response to ED treatment. Completely hard and fully rigid erections (grade 4) should be recognized as the optimal goal of an ED therapy. Evidence presented here demonstrates that sildenafil significantly improved EF as assessed by the IIEF EF domain and assessments of erection hardness in patients with ED; a dose-response relation was observed in the proportions of men with ED who graded their erections hard (rigid) enough for sexual penetration or completely hard and fully rigid.

Adult↗
PubMed1987

[Venous insufficiency of the corpora cavernosa as (additional) cause of erectile dysfunction].

In 25-30% of the patients with erectile dysfunction, venous insufficiency is the (additional) reason for the erectile failure. Surgical procedures and prognosis depend largely on the precise localisation of the pathological drainage. The venous leakage is proven and exactly localized by a multiprojectional cavernosography, measurement of the maintainance flow and intracavernous pressure monitoring. The most reliable screening test for venous erectile dysfunction is the intracavernous application of a standardised vasoactive drug combination.

Erectile Dysfunction↗
PubMed1987

Adherence to recommendations and improvement over time in men with erectile dysfunction.

Men with erectile problems seen for a comprehensive urology-department-based medical and psychological evaluation were sent questionnaires 2 to 3 years later. A representative sample of 99 (52%) responded. The majority (51%) has taken no action and reported that their sexual function was no better. Patients were more likely to comply with a recommendation for sex therapy than with one for a penile prosthesis. This was related to their attitude towards mental health professionals. These findings suggest the need for more knowledge of patient psychology and expectations.

Adult↗
PubMed2004

Erectile dysfunction and cardiovascular disease.

Cardiovascular disease and erectile dysfunction (ED) are closely interrelated disease processes. Erectile dysfunction reportedly affects 10 million to 20 million men in the United States and more than 100 million men worldwide. Each year, about 500,000 persons in the United States survive a myocardial infarction, and an estimated 11 million have existing cardiovascular disease, making the issue of sexual function and cardiac disease relevant to many patients. We explore the relationship between ED and the presence of cardiovascular disease in the general population. We also review the prevalence and pathophysiological associations of ED and cardiovascular disease. The risks of sexual activity for patients with cardiovascular disease are discussed, as are prevention and treatment strategies for ED in this patient population.

Cardiovascular Diseases↗
PubMed1996

Prevalence of self-reported erectile dysfunction in people with long-term IDDM.

OBJECTIVE: The purpose of this report is to examine the prevalence of erectile dysfunction and relationships to other characteristics in men with younger-onset diabetes. RESEARCH DESIGN AND METHODS: In a population-based cohort study in southern Wisconsin, prevalence of erectile dysfunction was measured based on self reports in men who were 21 years of age or older, were < 30 years of age at diagnosis of diabetes, had 10 or more years of diabetes, and were taking insulin (n = 365). RESULTS: Of the study group, 20% reported a history of erectile dysfunction. The prevalence of erectile dysfunction increased with increasing age (from 1.1% in those 21-30 years of age to 47.1% in those 43 years of age or older, P for trend < 0.0001) and with increasing duration of diabetes (P for trend < 0.0001). Erectile dysfunction was associated with presence of severe diabetic retinopathy, a history of peripheral neuropathy, amputation, cardiovascular disease, a higher glycosylated hemoglobin, use of antihypertensive medications, and higher BMI. CONCLUSIONS: These data suggest that tighter glycemic control and careful selection of antihypertensive medications might prove beneficial.

Adult↗
PubMed1999

The process of care model for evaluation and treatment of erectile dysfunction. The Process of Care Consensus Panel.

This paper addresses pertinent issues concerning the role of physicians in the assessment and treatment of men with complaints of erectile dysfunction. With the availability of safe and effective oral drug therapy, the field of erectile dysfunction has expanded rapidly to encompass multiple disciplines and specialties. Recognizing the need for evidence-based standards and guidelines in the management of this common disorder, a multidisciplinary panel of experts was convened to examine existing literature and practice standards. This panel employed a modified Delphi methodology to develop consensus on definition and classification, rational utilization of diagnostic and therapeutic options, and clinical guidelines for the management of erectile dysfunction in a primary care setting. A 'Process of Care Model for Erectile Dysfunction' was thus developed, incorporating a step-wise decision making approach, defined in terms of relevant processes, actions and outcomes. According to this method, initial assessment should include a careful clinical history, focused physical examination and selected laboratory tests. Subsequent management should be goal-oriented, taking into account patient and partner needs and preferences. The step-wise treatment algorithm is based on the selection criteria of ease of administration, reversibility, relative invasiveness and cost. In addition, common referral indications for specialized diagnostic testing and treatment are provided. By assisting the primary physician in selecting appropriate assessment tools and treatment interventions, the proposed guidelines are intended to optimize care of the patient with erectile dysfunction. The panel strongly recommends further research into the causes and associated risk factors for erectile dysfunction, prevention and the role of lifestyle modification, and the critical issue of partner-related sexual dysfunction. Considering the strong relationship between sexual dysfunction and overall quality of life, it is incumbent upon physicians to address the sexual needs of their patients in a sensitive and informed manner.

Adult↗
PubMed1999

Early relief of erectile dysfunction after laser decompression of herniated lumbar disc.

OBJECTIVE: The use of percutaneous laser disc decompression (PLDD) for the treatment of erectile dysfunction caused by herniated disc disease is described. SUMMARY BACKGROUND DATA: Disc herniation is often overlooked as a cause of erectile dysfunction, with few cases reported in the literature. METHODS: Two patients with erectile dysfunction were treated with PLDD as outpatients. RESULTS: In addition to the early return of erectile function in both cases, immediate pain relief was achieved in the second case. Follow-up visits confirmed continued normal sexual function and lack of pain. CONCLUSIONS: The literature now includes 23 cases well-documented cases of erectile dysfunction caused by spinal cord disc herniation. PLDD is a minimally invasive procedure that that can be used to treat herniation of intervertebral discs, which has been found to cause erectile dysfunction.

Adult↗
PubMed2004

Partner responses to sildenafil citrate (Viagra) treatment of erectile dysfunction.

OBJECTIVES: To evaluate in a pooled analysis of multiple studies the perceptions of effectiveness and overall treatment satisfaction in the partners of patients who received sildenafil citrate for treatment of erectile dysfunction. Partner satisfaction with treatment of erectile dysfunction can have a substantial impact on the continuation of therapy. METHODS: Each partner rated the man's erectile function and her own intercourse satisfaction by responding to three appropriately modified questions from the International Index of Erectile Function, assessing frequency of erections, ability to maintain erections, and satisfaction of intercourse in 14 double-blind placebo-controlled trials of sildenafil. Partner satisfaction with sildenafil treatment was evaluated using the Erectile Dysfunction Inventory of Treatment Satisfaction partner questionnaire in six of these trials. RESULTS: Of 3634 patients enrolled in these 14 trials, the partners of 930 patients agreed to participate. The partners reported that men receiving sildenafil had significantly greater erection frequency and ability to maintain erections than men receiving placebo, irrespective of patient age. Partners of sildenafil-treated men also had more frequent intercourse satisfaction compared with partners of placebo-treated men (P <0.0001). In both treatment groups, the partner and patient responses correlated highly (P <0.0001). The correlation between patient and partner Erectile Dysfunction Inventory of Treatment Satisfaction index scores was 0.80 for placebo and 0.86 for sildenafil (P <0.0001). CONCLUSIONS: Partner evaluations corroborated the patient assessments, with both indicating that treatment with sildenafil resulted in statistically significant improvement in erectile function and suggesting that partners were satisfied with sildenafil treatment for erectile dysfunction.

Adult↗
PubMed2003

Erectile dysfunction in the cardiac patient.

Erectile dysfunction (ED) often is caused by endothelial dysfunction and may be a sign that a patient has vascular disease elsewhere in the body. Risk factors for coronary artery disease such as lipid abnormalities, smoking, diabetes, and hypertension also are risk factors for ED. Oral therapy for ED, such as sildenafil, inhibits phosphodiesterase-5 (PDE-5) and the breakdown of cyclic guanosine monophosphate. PDE-5 inhibitors have been shown to be safe and effective for the therapy for ED, but remain contraindicated in patients receiving organic nitrates. These agents are mild vasodilators and are being investigated for their treatment potential for patients with pulmonary hypertension, heart failure, and endothelial dysfunction.

3',5'-Cyclic-GMP Phosphodiesterases↗
PubMed1999

Vacuum constriction devices for erectile dysfunction: a long-term, prospective study of patients with mild, moderate, and severe dysfunction.

OBJECTIVES: To evaluate, using a long-term, prospective study, the satisfaction rate, attrition rate, and follow-up treatment of well-trained patients using an external vacuum erection device, the Osbon ErecAid System, in the treatment of mild, moderate, and severe organic erectile dysfunction. METHODS: One hundred twenty-nine patients were assessed to determine the severity and cause of their erectile dysfunction. Patients with organic erectile dysfunction who were interested in the Osbon ErecAid received the device after thorough training. Patients received a follow-up questionnaire regarding satisfaction, months of use, reasons for discontinuing, and further treatment. RESULTS: Our attrition rate was 65% overall and was lowest among patients with moderate erectile dysfunction (55%). All patients with mild dysfunction discontinued use, and a large number (70%) of patients with complete dysfunction also discontinued use. Of the patients who discontinued, most stopped treatment early (median 1 month, mean 4 months) and 63% did not seek further treatment. Thirty-five percent of patients were satisfied with the device and have continued to use it long term (mean 37 months). CONCLUSIONS: Our study showed a lower success rate than previous reports. Patients who were satisfied with the Osbon ErecAid continued to use it for long periods. Patients who were not satisfied dropped out very quickly, and many did not seek further treatment. Patients with moderate erectile dysfunction had a higher rate of success than patients with mild or severe erectile dysfunction.

Aged↗
PubMed2002

Erectile dysfunction in the 21st century: whom we can treat, whom we cannot treat and patient education.

Erectile dysfunction affects 31-52% of American men. Although considerable advances have been made in the diagnosis and treatment of erectile dysfunction in the past decade, more than 80% of men with erectile dysfunction are not treated because they do not seek medical attention or their physicians do not initiate a dialogue about sexual problems during their visits. This despite patients' desires to confront sexual problems and receive treatment. Most subgroups of men can now be effectively treated for sexual dysfunction. Although men with severe cardiac disease may require stabilization of their cardiac condition before treatment, most can successfully return to an active sex life. Some men, however, do not respond to the use of oral agents. These men can be treated with second- and third-line treatment modalities or with the newer concept of combined-modality treatment. Despite excellent treatment alternatives, many men have low libido or hypoactive sexual desire disorder. In the ultimate resolution of a patient's sexual dysfunction, physicians must open a free and sympathetic dialogue and offer a full spectrum of treatment modalities tailored to the individual patient and partner. If initial treatment modalities fail, more invasive alternatives or combination therapy should be offered to cure the patient's erectile dysfunction.

Erectile Dysfunction↗
PubMed2005

[Treatment of erectile dysfunction after radical retropubic prostatectomy with PDE5 inhibitor].

The rate of erectile dysfunction after radical retropubic prostatectomy is from 10% to 100%. The prevalence of erectile dysfunction after nerve-sparing radical prostatectomy is more than one third. In the patients who had undergone bilateral NS, 72% responded to sildenafil, 71.7% and 59.7% responded to 20 mg and 10 mg of vardenafil respectively. For all randomized patients who received tadalafil, the mean percentage of successful penetration attempts was 54% and the mean percentage of successful intercourse attempts was 41%. For the subgroup with evidence of postoperative tumescence these values were 69% and 52%, respectively. No head-to-head trials have been performed with sildenafil, vardenafil and tadalafil in treatment of erectile dysfunction after radical prostatectomy.

Carbolines↗
PubMed2000

The mutually reinforcing triad of depressive symptoms, cardiovascular disease, and erectile dysfunction.

The conditions of depression, erectile dysfunction (ED), and cardiovascular disease may seem at a superficial level as independent medical problems managed by 3 separate and unrelated healthcare disciplines. Various studies, however, have revealed significant associations between depression and cardiovascular disease, ED and cardiovascular disease, and depression and ED. The purpose of this research was to identify whether the 3 medical conditions share mutually reinforcing associations and predictors. Population-based epidemiologic studies were utilized where possible. Variables including age, heart disease, hypertension, sedentary behavior, related medications, cigarette smoking, and abnormal lipids have been found to be highly associated with depressive symptoms, cardiovascular disease, and ED. It was concluded that all 3 medical conditions share many of the same risk factors and etiologic associations and may be best modeled in a 3-way holistic, mutually reinforcing relation. Of particular relevance, patients with sexual dysfunction have a likely comorbidity of cardiovascular disease and depression, as well as the potential increased risk for cardiac morbidity and mortality.

Causality↗
PubMed2006

The effect of diabetes mellitus treatment and good glycemic control on the erectile function in men with diabetes mellitus-induced erectile dysfunction: a pilot study.

INTRODUCTION: Erectile dysfunction (ED) is a common complication of diabetes mellitus (DM). However, efficacy and/or long-term satisfaction with most of those ED treatment options have been suboptimal. AIM: In this study we try to evaluate the effect of aggressive treatment and DM regulation on the erectile function in men with DM-induced ED (DMED). METHODS: Eight type 1 and 17 type 2 diabetic subjects were included into the study. All patients had a measurement of fasting plasma glucose (FPG) and glycosylated hemoglobin (HbA1(c)) levels, and completed three sessions of consecutive nights using the RigiScan Plus monitoring device before and after blood sugar control. Also International Index of Erectile Function (IIEF) questionnaire scores were obtained before and after blood sugar control. RESULTS: Significant improvement was noted in FPG and HbA1(c) levels throughout the treatment period (P < 0.001). However, no statistically significant difference was observed in both IIEF scores and nocturnal penile tumescence and rigidity (nptr) parameters after the dm regulation (p > 0.05). CONCLUSION: We suggest that there are probably other factors than aggressive treatment and DM regulation for treating DMED, and probably we must consider preventive strategies with pharmacological agents to prevent progressive decrease in erectile function in diabetic patients.

Adult↗