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Results for “Erectile Dysfunction”

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PubMed2006

Determination of changes in blood pressure during administration of sildenafil (Viagra) in patients with spinal cord injury and erectile dysfunction.

STUDY DESIGN: Prospective, open-label, comparative study, to assess the effects of sildenafil on blood pressure in a population of patients with spinal cord injury (SCI). OBJECTIVES: To determine the effect of sildenafil on blood pressure in patients with erectile dysfunction secondary to SCI by comparing changes in blood pressure in SCI patients with a neurologic level below T5 versus higher levels. To establish a relationship between the potential hypotensive effect and protective muscle spasm against blood pressure reduction. To assess the effects of age, complexity and duration of SCI on changes in blood pressure. To record any adverse effects occurring during the study. SETTING: Spinal Cord Injury Unit, Insular University Hospital of Gran Canaria, Canary Islands, Spain. SUBJECTS: In total, 22 male SCI patients aged 18 years or older with a history of SCI greater than 3 months in duration. METHODS: Patients with erectile dysfunction secondary to SCI were included in the study, without excluding patients with a neurologic level above 75 or asymptomatic low blood pressure. Patients with specific contraindications for use of the drug were excluded. A personal history was obtained, and the level of injury (ASIA/IMSOP scales of international standards), impairment grade (ASIA impairment scale), spasticity grade (modified Ashworth scale) and baseline sitting and supine blood pressure values were determined. A single dose of 50 mg of sildenafil was administered, and patients remained sitting at 45 degrees . Blood pressure was monitored every 10 min for 4 h and whenever the patient reported symptoms. Any relevant signs and symptoms manifested during the study period were also recorded. Analysis of the changes in blood pressure values was performed using a paired t-test in each group of patients according to neurologic level and spasticity grade. RESULTS: A decrease in blood pressure was observed in all patients, although patients with a level of injury at T5 or above and those with a complete SCI showed a less intense decrease (P<0.05). The spasticity grade of the patients was protective against the fall in blood pressure, as it was less significant in patients with grade 3 (P>0.1) than in those with grade 0. Adverse effects were few and transient. None were related to hypotension. CONCLUSION: Sildenafil caused a decrease in blood pressure in SCI patients with a neurologic level of injury above T5 and complete injuries (grade A), but did not have clinical implications in the patients studied. A higher spasticity grade tends to protect the patient from the fall in blood pressure. Age and duration of injury do not appear to influence this decrease.

Adult↗

PubMed2004

Specific aspects of erectile dysfunction in psychiatry.

The participation of the psychiatrist in the management of erectile dysfunction (ED) is focused on three types of patients based on the origin of the dysfunction: (1) patients with functional or psychogenic ED, (2) patients with mixed, organic psychogenic ED, and (3) patients with ED and active psychopathology. The second group is influenced by three psychological factors: perpetuating factors, aggravating factors, and accompanying factors. The main psychopathological disorders that interfere directly with the erectile mechanism are depressive disorders (18-35%), anxiety disorders (37%), obsessive-compulsive disorder, psychotic disorders (46-47%), and the antipsychotic medications used to treat these disorders. The diagnostic proposal includes psychological and sexologic evaluation and differential diagnosis. The therapeutic proposal includes the basic principles of sex therapy in the model of behavioral-cognitive therapy (eg, prohibition of intercourse, sensate focus, voluntary loss of erections, no expectations about response), pharmacological therapy (eg, sildenafil, intracavernous injection of vasoactive drugs), and a combination of both therapies.

Antipsychotic Agents↗

PubMedDate not supplied

[A trial of the use pf prostaglandin E1 (Edex, Caverject) for the diagnosis and treatment of erectile dysfunction].

The authors have examined 48 patients aged 17-70 years with erectile disorders. In 15 cases sexual adaptation was achieved after teaching them autoinjections. Pharmacological aid with PGE1 (Edex, Caverject) proved effective for sexual adaptation of patients with erectile disorders. In case of well adjusted dose and strict compliance of the autoinjection regimen the number of complications was minimal. In 50-70-year-olds PGE1 do not cause systemic complications due to pharmacokinetics and endogenic nature of PGE1. This prostaglandin is highly effective in some forms of psychogenic erectile dysfunction especially in expecting failure. For such patients 1 or 2 autoinjections of minimal dose are enough to correct erection.

Adolescent↗

PubMed1999

[Long-term results of venous surgery for cavernous erectile dysfunction].

BACKGROUND: It is well known that the effectiveness of venous surgery declines during the follow-up period. The onset of recurrence after surgery varies greatly among patients. There are only a few studies which have evaluated the effectiveness of venous surgery with objective tests. METHODS: We treated 123 cases of cavernous erectile dysfunction with venous surgery, and evaluated the results objectively. We performed intracavernous injection tests using 20 micrograms of prostaglandin E1 every 3 months until the recurrence of cavernous erectile dysfunction. RESULTS: Mean follow up period was 32 months (0.2-134.0 months). According to the Kaplan-Meier analysis, the effectiveness of surgery at 1 year, 3 years, 5 years, and 10 years was 85%, 61%, 30%, and 26%, respectively. CONCLUSION: There was no statistically significant difference between the outcomes following deep dorsal vein surgery and crural ligation surgery. Operative complications were more frequent, however in deep dorsal vein surgery.

Adult↗

PubMed2006

Vascular erectile dysfunction in chronic renal failure.

The prevalence of erectile dysfunction (ED) has increased dramatically worldwide in parallel with the aging of the population. In 1995, ED was estimated to be present in more than 150 million men. Considering population aging in Western countries, estimates predict that more than 300 million men will be affected by ED by the year 2025. ED is a common and often distressing side effect of renal failure. It is present in 30% of patients with chronic renal failure and in 50% of patients undergoing dialysis treatment. Uremic men of different ages report a high variety of sexual problems including sexual hormonal pattern alterations, reduced or loss of libido, infertility, and impotence, thereby influencing their well-being. The pathogenetic mechanisms include physiologic, psychologic, and organic causes. Since the release of sildenafil citrate, the relationship between ED and the presence of cardiovascular disease (CVD) has been evaluated in several studies. Many of the risk factors for ED are the same as those for cardiac disease. CVD and ED are closely interrelated disease processes. Indeed, ED can be considered a symptom of vascular endothelial damage. Therefore, it can be expected that impotence will appear along with CVD, and the presence of ED suggests the existence of CVD. An accurate evaluation of the sexual histories of all men who present to internists, cardiologists, and also nephrologists for early detection of ED may allow for early diagnosis and management of CVD.

Humans↗

PubMed1992

Manually assisted ejaculation in a stallion with erectile dysfunction subsequent to paraphimosis.

A Thoroughbred stallion with erectile dysfunction following paraphimosis was managed to allow consistent ejaculation. Ejaculation was elicited in this stallion by applying manual stimulation to the base of the penis. This technique allowed consistent ejaculation, and the stallion was able to return to natural service. Historically, stallions with this degree of penile dysfunction have been considered incapable of ejaculation and unable to continue as breeding animals.

Animals↗

PubMed1991

Erectile dysfunction following direct vision internal urethrotomy.

A total of 104 evaluable patients 20-90 years old treated by direct vision internal urethrotomy a.m. Sachse for urethral strictures reported retrospectively via a questionnaire their sexual potency before and after internal urethrotomy. Eleven patients (10.6%) experienced partial or total erectile dysfunction following the operation, most of whom had distal and long strictures. Eight were evaluated for impotence and on grounds of a comprehensive history, physical examination, penile Doppler investigations, and papaverine tests it was concluded that 3 patients might have achieved an abnormal communication between the corpus cavernosum and corpus spongiosum. In two of the patients cavernosographies were carried out and in one total opacification of the corpus spongiosum was demonstrated, but the exact location of the leak could not be pinpointed, and surgical treatment therefore not rendered feasible. Possible factors in the development of erectile dysfunction following internal urethrotomy are analyzed.

Adult↗

PubMed2001

Erectile dysfunction in a primary care setting: results of an observational, no-control-group, prospective study with sildenafil under routine conditions of use.

In order to assess the effectiveness of sildenafil under routine conditions of use in primary care settings and to evaluate its impact on patient's life satisfaction and partner's satisfaction with treatment for erectile dysfunction (ED), an open, multicentre, observational, prospective study was designed in which 2816 patients were treated with sildenafil for at least 10 weeks. Effectiveness was assessed using the International Index of Erectile Dysfunction (IIEF), life satisfaction was measured with 'Life-satisfaction Check List' (LISAT 8), and EDITS was optionally used to assess the partner's satisfaction with ED therapy. Sildenafil was effective in 86.6% of patients. All dimensions of IIEF significantly increased with sildenafil, particularly erectile domain which overall sample mean score improved was 13.2 points (P < 0.001). The greatest increases in satisfaction with all aspects of life were seen in sex life and relationship with partner dimensions. The patients' partners, answered by a minority of partners, were highly satisfied with the treatment and its rapid action, therefore they were in favour of continuing with same. The adverse events occurring were similar to those seen in clinical research on sildenafil in the premarketing phase. No control group was included in this study.

Erectile Dysfunction↗

PubMedDate not supplied

Erectile dysfunction: assessment, treatment and prescribing issues.

Because of the sensitive nature of erectile dysfunction, epidemiology may be based on conservative estimates. Today, oral medication is regularly prescribed, often in the primary care setting, although this may be at the expense of accurate patient assessment. Government restrictions on ED treatment are an obstacle for patients seeking help and may result in their financing themselves.

Erectile Dysfunction↗

PubMed2001

Traumatic arteriogenic erectile dysfunction: a rat model.

We developed a rat model of traumatic arteriogenic erectile dysfunction (ED) for the study of vasculogenic ED. Bilateral ligation of the internal iliac artery was performed on 30 three-month old male Sprague-Dawley rats as an experimental group. The control group consisted of 12 rats which underwent dissection of the internal iliac artery without ligation. Before their euthanization at 3 days, 7 days, and 1 month (10 rats in the experimental group and four rats in the control group at each time point), erectile function was assessed by electrostimulation of the cavernous nerves. Penile tissues were collected for nicotinamide adenine dinucleotide phosphate (NADPH) diaphorase staining, trichrome staining, electron microscopy and RT-PCR for transforming growth factor beta (TGF-beta1), insulin like growth factor-I (IGF-I) and fibroblast growth factors (FGF) mRNA expression. Electrostimulation of the cavernous nerves revealed a highly significant declining of the intracavernous pressure after 3 and 7 days. No significant recovery of erectile function was noted at 1 month. Histology showed degeneration of the dorsal nerve fibers in all experimental rats. There was little decrease in the bulk of intracavernous smooth muscle in the experimental rats euthanazed 7 and 30 days. NADPH diaphorase staining revealed a significant decrease in nitric oxide synthase (NOS) containing nerve fibers in the dorsal and intracavernosal nerves in all rats in the experimental group. Electron microscopy showed a variety of changes such as collapse of sinusoids, increased cell debris, fibroblast and myofibroblast loss, intracellular deposition of fat and collagen and fatty degeneration. RT-PCR revealed up-regulation of TGF-beta1 after 3 days but not after 7 days or 1 month. There is no significant difference in IGF-I or FGF expression between the experimental and control group. Bilateral ligation of internal iliac arteries produces a reliable animal model for traumatic arteriogenic ED. Further studies are needed to investigate the molecular mechanism of ED in this model.

Animals↗

PubMed2006

[Role of female partners in the diagnosis and treatment of erectile dysfunction].

The role of female partners in the diagnosis and treatment of erectile dysfunction (ED) is being paid more and more attention now. ED has serious adverse effects on the sexual experience of female partners, while the attitudes of female partners to ED will have a direct effect on seeking and continuing treatment behavior of ED patients. So it's necessary for clinicians to consider female partners in the clinical practice of ED. The evidence from a recently published clinical trial has demonstrated that vardenafil not only improved ED men's erectile function, but also improved the sexual quality of life for female partners, which was the ideal solution of ED couples.

Erectile Dysfunction↗

PubMed2004

[Physiology and pathophysiology of erectile dysfunction. A modern contrivance?].

Notions and hypotheses of the pathophysiologic process in erectile dysfunction--its errors and embarrassment--are focused on beginning with Aristotle and continued in the Renaissance and the Enlightenment. Only in the middle of the nineteenth century was there recognition of the central role of relaxation of the trabecular muscles. It took another 100 years until we had a useful treatment option at hand.

Erectile Dysfunction↗

PubMedDate not supplied

Efficacy of tadalafil in the treatment of erectile dysfunction in hypertensive men on concomitant thiazide diuretic therapy.

Many men with erectile dysfunction (ED) have hypertension as a comorbid condition. Recent guidelines recommend thiazide diuretics as first-line therapy for hypertension. We analyzed data from 14 randomized, double-blind, placebo-controlled trials (N=2501) to evaluate the efficacy of tadalafil 20 mg for the treatment of ED in men on thiazides. Of the 2501 patients, 163 were on concomitant thiazides (116 tadalafil/47 placebo) and 159 (98%) were reported to have hypertension. The primary efficacy measures were mean change from baseline in the international index of erectile function (IIEF) erectile function (EF) domain and the proportion of 'yes' responses to sexual encounter profile (SEP) Questions 2 and 3. The tadalafil group showed a significantly (P<0.001) greater mean baseline to endpoint improvement on all efficacy outcome measures compared to placebo-treated patients regardless of concomitant thiazide use. More importantly, the responses to tadalafil were similar regardless of concomitant thiazide use. Additionally, responses to tadalafil were comparable between thiazide and nonthiazide users regardless of baseline ED severity (P>0.05).

Adult↗

PubMed2003

A baseline-controlled, open-label, flexible dose-escalation study to assess the safety and efficacy of sildenafil citrate (Viagra) in patients with erectile dysfunction.

Although sildenafil citrate (Viagra) has demonstrated effectiveness in the treatment of erectile dysfunction (ED), the dosing regimens often used in clinical trials may not always match those employed in clinical practice. This study was undertaken to further assess the efficacy and safety of sildenafil taken as required in male outpatients 18 years of age and older with ED (n=71). It was conducted as a placebo-baseline-controlled, open-label, flexible dose-escalation study, with sildenafil (25,50, or 100 mg) administered for 8 weeks following a 4-week placebo run-in. Efficacy variables included questions 3 and 4 of the International Index of Erectile Function (IIEF), other IIEF domains, patient event logs, and quality-of-life (QOL) assessments. Treatment with sildenafil resulted in improvements from baseline in all IIEF domains analyzed (all P<0.0001), as well as overall QOL and amelioration of specific sexual and social relationships (all P&<0.0001). Sildenafil was well tolerated. One participant discontinued treatment because of adverse events. Results suggest that flexible dosing with oral sildenafil is safe and has beneficial effects on all indices of erectile function and QOL.

Adult↗

PubMed1988

Erectile dysfunction due to ectopic penile vein.

A total of 86/260 patients with erectile dysfunction had venous leakage as (joint) etiology. In 5 of 86 patients cavernosography showed pathologic cavernosal drainage only via an ectopic penile vein into the femoral vein. After ligation of this pathologic draining vessel, 4 of 5 patients regained spontaneous erectability. One patient with pathologic bulbocavernosus reflex latencies needed intracavernosal injection of vasoactive drugs for full rigidity.

Adult↗

PubMed2003

Erectile dysfunction: why drug therapy isn't always enough.

We increasingly recognize that erectile dysfunction (ED) usually arises from a mix of organic and psychogenic causes, yet management of this condition too often neglects the complexity of most cases of ED. While therapy with sildenafil and similar investigational drugs can play an important role in many cases of ED, physicians should recognize and try to address the psychological and interpersonal context in which ED exists in their patients.

Age Distribution↗

PubMed2006

[Reliable efficacy of vardenafil for treatment of erectile dysfunction].

Reliable efficacy is very important to continuing treatment for patients with erectile dysfunction. Vardenafil is a potent, highly selective phosphodiesterase 5 (PDE5) inhibitor. The efficacy and safety of vardenafil has been confirmed in many clinical studies. This paper analyzed the efficacy reliability of vardenafil in clinical trials and real-life practice, concluded that it provided reliable efficacy for key parameters of erection and improved treatment compliance.

Adult↗

PubMedDate not supplied

Erectile dysfunction following treatments of benign prostatic hyperplasia: a prospective study.

The effects of open prostatectomy, transurethral resection, transurethral vaporization, doxazosin and finasteride on sexual functions of men were investigated in a total of 305 patients with benign prostatic hyperplasia. The sexual functions of the patients were assessed with a questionnaire before treatment and 3 and 6 months after the treatment. A total of 212 (70%) patients were judged to be potent before the treatment. At 3 months, open prostatectomy and transurethral resection caused erectile dysfunction in 2 of 40 (5%) and 5 of 89 (6%) potent patients, respectively. At 6 months, one of the patients from the former and 2 of the patients from the latter groups who developed erectile dysfunction at 3 months stated improvement. Transurethral vaporization caused loss of erectile functions in 4 of 14 potent patients (29%) at the 3-month follow-up and, one of these patients recovered erectile functions at 6 months. Only one of the 33 patients (3%) using doxazosin stated that he lost his erectile functions both at 3 months and 6 months. At 3 months follow-up, finasteride caused loss of erectile functions in 8 of 36 potent patients (22%). Four of these patients underwent surgery (transurethral resection) after 3 months of finasteride use. At the 6-month follow-up, 4 more patients suffered from loss of erectile functions. We suggest that finasteride and transurethral vaporization have the greatest potential of impairing the sexual functions among the treatment options investigated in this study and that they must be carefully offered to the potent patients.

Adrenergic alpha-Antagonists↗