Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “IMPOTENCE”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

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

At least 379 records · Page 21Linked to original sources
PubMed1991

The management of impotence in diabetic men by vacuum tumescence therapy.

The treatment of impotence in diabetic men with vacuum tumescence therapy was studied in a specialist clinic. Of 54 diabetic men referred with impotence, seven declined treatment, three chose self-injection with papaverine, and 44 chose vacuum therapy. Patients underwent autonomic function testing (heart rate response to respiration), measurement of penile blood flow (duplex Doppler scanning), and estimation of serum prolactin and testosterone levels. After 2 months, 33 men (75%) were able to have satisfactory intercourse using vacuum therapy. Three others could produce a satisfactory erection with vacuum therapy but their partners found it unacceptable. Eight men (18%) were unable to have satisfactory intercourse; six of these were later treated by self-injection. The median frequency of use of vacuum therapy was 5.5 (1-26) times a month. Outcome was independent of penile blood flow, autonomic function or endocrine status. Impotent diabetic men should be given counselling and offered a choice of the available treatments. Vacuum tumescence therapy is an effective and simple treatment which requires little investigation.

Diabetes Mellitus↗
PubMed1988

Impotence and aging: clinical and hormonal factors.

A cross-sectional study of 216 impotent men aged 40 to 79 years (mean age 60.9 years) was conducted to determine if there are age-related changes in clinical and hormonal parameters in an impotent population. There was a slight increase in the degree of sexual dysfunction with age, with complete erectile failure occurring in a larger percent of the 60- and 70-year-olds than in the younger patients (41% vs 27% for the 40 year olds, P less than .05). No patient above the age of 70 years reported any full erections, even of short duration. In contrast, reported levels of libido did not vary significantly with age. Abnormal penile Doppler studies diagnostic of vasculogenic impotence were found in 17.8% of the patients tested, and an additional 17.8% were found to have evidence suggestive of a vascular etiology. These abnormal vascular findings were associated with an extremely high prevalence of clinically apparent atherosclerosis in this population. In 22.9% of the subjects, an abnormal vascular response was found only on exercise, ie, a "pelvic steal", which only occurred above the age of 50 years. There was a marked age-related alteration in the concentration of testosterone (T) and bioavailable testosterone (BT), but no statistically significant change in the levels of gonadotropins with age. An increase in the prevalence of eugonadotropic hypogonadism with age was found, which suggested an increasing prevalence of hypothalamic pituitary dysfunction in this patient group. For both vascular and hormonal changes (such as low T and BT), the greatest changes appear to occur after the age of 50.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Use of a vacuum tumescence device in the management of impotence.

This study evaluated the use of a vacuum tumescence device in the treatment of impotence in older men. Twenty couples with sexual dysfunction due to erectile impotence and who were interested in restoration of sexual function were treated by providing them with both a vacuum tumescence device to engorge the penis and an obstructing band to impede venous return. Nineteen patients established firm to hard erections lasting an average of 16 minutes and were able to have satisfactory coitus with vaginal ejaculation an average of three times per month. The penile-brachial pressure index, supine and after exercise (a measure of the adequacy of penile arterial flow), exhibited a significant increase following six month's use of the vacuum tumescence device. The only significant complications were mild, self-limited hematomas on three occasions of use. Thus in this limited series the vacuum tumescence device provided a well-accepted, relatively inexpensive therapeutic approach to impotence.

Aged↗
PubMed1992

Use of a vacuum tumescence device in the management of impotence in men with a history of penile implant or severe pelvic disease.

PURPOSE: To evaluate the use of a vacuum tumescence device in the treatment of impotence in couples wishing to restore coital function, whose male partners had unsatisfactory results from penile implants or in whom the man was impotent following treatment for prostate or colon carcinoma. SUBJECTS: Convenience sample of seventeen couples seeking treatment of male factor sexual dysfunction. METHODS: After completion of a comprehensive diagnostic evaluation of the male partner, couples who expressed a wish to restore coital function were instructed in the use of the vacuum tumescence device. Partners each filled out and initialled a daily diary of sexual activity and returned to clinic for followup at 3 and 6 months. RESULTS: Sixteen patients were able to obtain firm to hard erections lasting an average of 14.9 minutes and had satisfactory coitus with vaginal ejaculation an average of 3.9 times per month. There were no significant complications. CONCLUSION: The vacuum tumescence device can be effective in the treatment of impotence after penile prosthesis explantation, in enhancement of inadequate erections with a prosthesis in place, and after surgical or radiation therapy for prostate or colon carcinoma.

Aged↗
PubMed1985

The value of somatosensory-evoked potentials and bulbocavernosus reflex in patients with impotence.

In 14 normal male adults and 97 male patients having impotence alone or together with systematic and/or neuro-psychiatric symptoms and signs, the somatosensory cerebral-evoked potentials were obtained by glans penis stimulation (penile SEP); by peroneal nerve stimulation (peroneal SEP) and by electrically-induced bulbocavernous (BC) reflex. In normal subjects, the configurations of both SEPs were basically similar, except that the onset of latency was 10-15 msec longer and the amplitude in the P1-N1 component was higher in penile SEP. BC-reflex latency was abnormally prolonged, especially in diabetic impotence and in patients with cauda/conus lesions, while the abnormalities on the penile and peroneal SEP were more frequent in patients with spinal cord injuries. MS and parkinsonism. In impotent patients with epilepsy, chronic prostatis and psychogenic problems, all the tests were generally normal.

Adolescent↗
PubMed1997

Impotence and nerve entrapment in long distance amateur cyclists.

OBJECTIVES: To assess the frequency and duration of symptoms suggesting peripheral nerve compression after long distance cycling. MATERIAL AND METHODS: A questionnaire based cross sectional study among 260 participants in a Norwegian annual bicycle touring race of 540 km. RESULTS: Thirty-five of 160 responding males (22%) reported symptoms from the innervation area of the pudendal or cavernous nerves. Thirty-three had penile numbness or hypaesthesia after the tour. In 10, the numbness lasted for more than one week. Impotence was reported by 21 (13%) of the males. It lasted for more than one week in 11, and for more than one month in three. Both genital numbness and impotence were correlated with weakness in the hands after the ride, a complaint reported by 32 (19%) of all 169 respondents. Forty-six cyclists (30%) indicated paraesthesia or numbness in the fingers, half of them from the ulnar nerve area only. CONCLUSION: The frequency of impotence, numbness of the penis, hand weakness and sensory symptoms from the fingers in bicycle sport may be higher than hitherto recognized. It afflicts both experienced cyclists and novices. In some, the complaints may last up to eight months. Besides changing the hand and body position on the bike, restricting the training intensity, and taking ample pauses may also be necessary in prolonged and vigorous bicycle riding to prevent damage to peripheral nerves.

Athletic Injuries↗
PubMed1999

Impaired ascendant central pathways conduction in impotent diabetic subjects.

OBJECTIVES: Diabetic impotence is generally due to peripheral neuropathy, but a central pathway impairment has also been suggested. We evaluated somatosensory transmission in a group of impotent diabetic men to assess the role of central nervous system (CNS) involvement. MATERIALS AND METHODS: Somatosensory evoked potentials (SEPs) of pudendal (pdn) and posterior tibial (ptn) nerves were recorded in 74 patients. Type and duration of diabetes, severity of sexual dysfunction, medium term metabolic control, occurrence of microangiopathic chronic complications and autonomic neuropathy were evaluated. RESULTS: Our data show an impairment of central conduction times in pdn (25.7%) and ptn (39.2%) greater than peripheral nervous impairment (pdn 12.2%, ptn 8.1%), in impotent diabetic patients without any further major complication. Central nervous conduction delay resulted to be correlated with poor glycemic control. Significant evident autonomic dysfunction was found only in a minority of cases. CONCLUSION: Our data might suggest that altered conduction along CNS and somatic peripheral neuropathy might develop independently. We confirm the hypothesis of a "central diabetic neuropathy" and suggest that central sensory pathways involvement, not related to peripheral impairment, could play a role in the pathogenesis of erectile dysfunction in diabetic patients.

Adult↗
PubMed1974

Plasma testosterone and testosterone binding affinities in men with impotence, oligospermia, azoospermia, and hypogonadism.

Mean plasma testosterone levels (+/- S.D.), using Sephadex LH-20 and competitive protein binding, were 629 +/- 160 ng/100 ml for a group of 27 normal adult men, 650 +/- 205 ng/100 ml for 27 impotent men with normal secondary sex characteristics, 644 +/- 178 ng/100 ml for 20 men with oligospermia, and 563 +/- 125 ng/100 ml for 16 azoospermic men. None of these values differ significantly. For 21 men with clinical evidence of hypogonadism the mean plasma testosterone (+/- S.D.), at 177 +/- 122 ng/100 ml, differed significantly (P < 0.001) from that of the normal men.The mean testosterone binding affinities (as measured by the reciprocal of the quantity of plasma needed to bind 50% of (3)H-testosterone tracer) were similar for normal, impotent, and oligospermic men. Though lower for azoospermic men the difference was not significant (P >0.1). For 12 of the 16 hypogonadal males the testosterone binding affinity was normal, but raised binding affinities, similar to those found in normal adult females or prepubertal boys (about twice normal adult male levels), were found in four cases of delayed puberty. These findings help to explain why androgen therapy is usually useless in the treatment of impotence.

Adult↗
PubMed1988

Successful non-invasive management of erectile impotence in diabetic men.

The effectiveness of a device designed to overcome erectile impotence was assessed in 10 insulin dependent diabetics with no other cause for their erectile impotence. The 10 men and their partners were instructed how to use the device, which uses suction to induce penile engorgement and maintains erection with a constriction band. After three months they answered a questionnaire about its effectiveness and acceptability, assessing these by visual analogue scales. All the patients achieved lasting erections with the device and gave high mean scores for ease of use, effectiveness, and satisfaction, but three partners refused to complete the questionnaire having failed to come to terms with using the device. One couple stopped using it because of marital disharmony. This device provides a practical alternative for the treatment of erectile impotence in diabetic men. Unlike invasive treatments, it does not necessitate lengthy assessments of autonomic, endocrine, and erectile function and is safe to use and relatively cheap.

Adult↗
PubMed1970

Androgen function in "psychogenic" and "constitutional" types of impotence.

Androgen function was studied in twenty-five physically healthy "primarily" impotent males classified on clinical criteria into "psychogenic" or "constitutional" groups. The mean urinary testosterone level in the former was significantly higher than in the latter group (P<0.005). Important variables associated significantly with higher urinary testosterone levels (P<0.05) were (a) "late onset" impotence, (b) shorter duration than two years, (c) stronger "sex drive," and (d) an alternative sexual outlet to orgasm and ejaculation in the three months preceding referral; the last-mentioned appeared to be the single most important discriminatory feature.It is suggested that testosterone excretion patterns-namely, high, average, and low-may be one method of classifying impotence.

Adolescent↗
PubMed1986

Impotence: evaluation with cavernosography.

Many patients with organic impotence do not have abnormalities of the penile arterial system. To determine the function of the venous system in erection, cavernosography was performed in 187 impotent men during artificial induction of erection with monitoring of intracavernous pressure and inflow. To evaluate the mechanism of active erection, 69 patients also received intracavernous injections of papaverine. Venous leakage was found in 88 patients. In these patients, a higher than normal rate of flow of diluted, heparinized contrast medium was required to initiate and maintain erection. Opacification of the prostatic plexus also occurred during erection in these patients. In all patients who received papaverine, the flow rates required to initiate and maintain erection decreased. The authors conclude that cavernosography and cavernometry are essential in the work-up of impotence and that papaverine may be helpful in elucidating the active mechanism of erection.

Adolescent↗
PubMed1998

Prevalence and impact of incontinence and impotence following total prostatectomy assessed anonymously by the ICS-male questionnaire.

OBJECTIVES: The aim of this study was to assess the incidence of incontinence and impotence in patients following total prostatectomy and assess the impact their symptoms have on their quality of life. PATIENTS AND METHODS: Between 1987 and 1994, one surgeon performed retropubic total prostatectomies on 89 patients, of which 87 were available for follow-up. All patients were sent an ICS-male questionnaire. Patients' ages ranged from 49 to 73 years (median 65). The interval between surgery and completing the questionnaire ranged from 7 to 87 months (median 22). RESULTS: The response rate was 95%. No patients reported incontinence pre-operatively. Postoperatively, 69% (57/83) of patients suffered to some degree of leakage of urine and 24% (29/83) used pads. Of these, 60% used 1 pad per day, 15% 2 pads and 25% (5 patients) used 3 or more. Nocturnal incontinence was reported by 20% of patients. Urinary incontinence was considered a problem in only 34% (28/83) of patients. Sixty-five percent of patients using pads considered urinary leakage to be a problem, but only 1 considered it a serious problem. 89% claimed to have been potent prior to surgery. The overall postoperative potency rate was 41% (30/74) in those potent pre-operatively. However, 67% of patients reporting potency had severely reduced rigidity, and only 12% (9/74) achieved what they considered full erections. Ten percent of all patients considered postoperative impotence to be a serious problem, and 47% stated that it was not a problem at all. CONCLUSIONS: The incidence of incontinence and impotence following total prostatectomy is higher than earlier reports suggest, but the impact of these complications appears to be surprisingly low. These results allow patients to be given realistic expectations when counselled prior to this operation.

Aged↗
PubMed1982

Erectile impotence--clinical experience with the phalloplethysmography.

The clinical experience and results of NPT recording on three different groups of patients (a group of normals, a group with high suspicion of psychogenic impotence and a group of organic impotence with a well-known etiology) are reported here. A new classification of erectile capacity which is not only based on change in circumference of the penis, but also on duration of complete erection and rigidity of the penis is proposed. The phalloplethysmography, which is based on the REM-related tumescence is a reliable method for discrimination between organic and psychogenic impotence. A rigidity test, however, is essentially for the detection of insufficient rigidity in spite of normal penile expansion during NPT recording.

Adult↗
PubMed1989

Human penile erection and organic impotence: normal histology and histopathology.

A very large amount of human material (7 embryos, 12 stillborns, 12 penes of males aged between 2 and 86 years, as well as bioptical material from 80 subjects affected by impotence problems) has been examined so as to study the penis arterial and venous walls, the blood flow regulation mechanisms and the intracavernal trabecular morphology. The amount of muscle tissue and of collagenous connective tissue has been numerically quantified by computer-assisted methods. This study enables the authors to underline three fundamental facts: (a) it confirms the normal penile erection mechanism, and the consequent theory, (b) it confirms that vascular sclerosis is a systemic phenomenon correlated to age, and that the penis is not exempt, and (c) in the case of impotence problems, the same sclerosis phenomenon may appear at an earlier age, and therefore induce pathological impotence.

Aging↗
PubMed1991

Intracavernous injection of prostaglandin E1: the application to cavernosography and penile blood flow measurement for the diagnosis of venogenic impotence.

We injected 20 micrograms of prostaglandin E1 (PGE1) intracavernously in 32 patients with impotence, we then examined penile blood flow using a Xe-133 washout technique. In addition, we also performed a cavernosography. After PGE1 injection, 18 patients (56%) showed complete erection, 10 (31%) tumescence, and 4 (13%) no response. Fourteen patients who presented either an inadequate or no response to PGE1 injection were suspected to have vasculogenic impotence. Cavernosography of patients who showed good response after PGE1 injection demonstrated no obvious venous leakage. In this group penile blood flow decreased after full erection. However, 7 patients (50%) suspected to have vascular problems showed venous leakage. Subsequently, these 7 patients appeared to be cases of venous incompetence. The penile blood flow of these 7 patients before or after PGE1 injection was not statistically different from that of other groups. Based on these findings, cavernosography after PGE1 injection appears to be useful for differentiating the venous factor of impotence.

Adult↗
PubMed1991

Impotence after radical pelvic surgery: physiology and management.

Impotence has been a common problem after radical surgery of the colon, rectum, prostate, bladder, and seminal vesicle. However, a better understanding of the neuroanatomy of erection has resulted in its decline. When impotence does result, in cases where the extent of tumor involvement renders preservation of the neurovascular bundle impossible, the variety of treatments available is now improved: these include intracavernous injection of vasodilators, vacuum constriction devices, penile arterial and venous surgery, and penile prostheses. The improved understanding and management of impotence has greatly enhanced the quality of life of patients after radical pelvic surgery.

Erectile Dysfunction↗
PubMed1977

Impotence and diabetes mellitus.

Impotence is a rather frequent symptom in the diabetic patient. The aetiology of this problem is not clear. Urodynamic and hormonal examinations have been performed in a group of 10 diabetics with impotence in order to evaluate its neurogenic and endocrine factor. The determination of the parameters that effect micturition are dependent on the erector nerve, which at the same time participates in erection, demonstrating the existence of a neuropathy of the erector nerve and shows if it is responsible for the impotence. The hormonal examinations were all normal. The different urodynamic alterations which have been found are tabulated and the importance of a simple determination of voiding time, as a proof in the screening of these patients, is emphasized.

Adult↗
PubMed1986

Intracavernous therapy in impotence after pelvic trauma. A preliminary study.

Pelvic trauma, especially when complicated by a posterior urethral disruption, may cause impotence in 50% of patients. The treatment of this kind of impotence has always been troublesome for the urologist. In fact penile prostheses or the revascularization procedures have sometimes been failures. We present a series of 6 patients with impotence after pelvic trauma managed by intracavernous injection of papaverine and we describe here the preliminary results obtained.

Adult↗