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At least 523 records · Page 29Linked to original sources
PubMed1986

Routine endocrine screening in impotence.

Routine hormonal screening (serum testosterone and prolactin) of 300 men presenting with a primary complaint of impotence resulted in detection of endocrine dysfunction in 5 men (1.7%). Four patients had hypogonadism, and 1 patient had a prolactin-secreting pituitary adenoma. The cost of screening these men for endocrine dysfunction was $34,722.00. Despite this cost and the low yield of endocrine disease detection, routine determination of serum testosterone and prolactin provides useful information to the clinician evaluating impotent men and when abnormal, indicates the need for thorough endocrine evaluation.

Adenoma↗
PubMed1987

Pharmacologic, nonhormonal treatment of impotence. Evaluation of associated factors.

A group of impotent patients previously treated with Strychiomel was evaluated. Strychiomel is a compound of three drugs, yohimbine, thioridazine (Mellaril), and strychnine sulfate, each of which has a specific effect. The results suggest that the compound drug may be beneficial in the majority of patients (66.7%) when impotence occurs without hormonal or severe vascular or psychologic problems. Other factors such as age or presence of other simultaneous diseases do not appear to be significant when treatment with this multiaction drug (Strychiomel) is utilized.

Adult↗
PubMed1987

New techniques in evaluation of impotence.

Two new methods of evaluating erectile function were compared and contrasted in a series of 41 patients complaining of impotence. The first method consisted of a single measurement of maximum rigidity at penile base and along the penile shaft utilizing Snap-Gauges. The second method consisted of simultaneous continuous monitoring of penile tumescence and rigidity of the penile base and shaft. The results demonstrated concurrence of interpretation of both techniques. However, whereas the results of Snap-Gauge testing clearly distinguished between organic and psychogenic impotence, continuous penile rigidity monitoring usually delineated the nature of the penile erectile abnormality.

Adult↗
PubMed1987

Penile self-injection for impotence in patients after radical cystectomy-ileal loop.

Eight patients with impotence following radical cystectomy and ileal loop surgery for cancer of the bladder were treated with a mixture of papaverine/phentolamine at 30/1 ratio. All but 1 patient had a successful result. In the majority of patients the duration of the erection was significantly less than in impotent patients with different causations.

Drug Combinations↗
PubMed1989

Diagnosis of vasculogenic impotence: combination of penile xenon-133 washout and papaverine tests.

The present study evaluates both penile xenon-133 washout (XWT) and papaverine tests (PT) in the diagnosis of vasculogenic impotence. XWT was accomplished by subcutaneous injection of xenon-133 (1-2 mCi in 0.1 mL saline solution) into the dorsal coronal prepuce. Abnormal XWT was suggested in patients whose clearance time (T1/2) was longer than 7.5 minutes and whose penile blood flow rate (Q) was less than 6 mL/100 g tissue/min. PT was done by intracavernous injection of papaverine (60 mg in 20 mL normal saline). Abnormal PT was indicated in patients whose onset of full erection was more than ten minutes after papaverine injection and whose duration of erection was less than one hour. Ten young and 11 older normal volunteers were examined with XWT only; all showed normal results. A total of 60 impotent patients were examined with both XWT and PT and were classified into four groups: in 2 patients (3.3%) both XWT and PT were normal (group I); in 8 (13.3%) XWT was abnormal and PT normal (group II); in 14 (23.3%) XWT was normal and PT abnormal (group III); and in 36 (60%) both XWT and PT were abnormal (group IV). On further examination with bilateral hypogastric arteriography in 10 XWT-abnormal patients and on surgical correction of abnormal curvature in 5 XWT-abnormal patients, all (100%) were proved to have penile arterial insufficiency. Erection cavernosography performed in 15 PT-abnormal patients confirmed penile venous insufficiency in 80 percent. We conclude both XWT and PT are simple and effective for evaluation of the penile arterial blood flow and venous competence, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Age-related changes in hormones in impotent men. Jefferson Sexual Function Center.

A total of 818 impotent men were evaluated in a multidisciplinary Sexual Function Center for reproductive hormone levels. Data are presented demonstrating an overall rate of endocrinopathy at 19.3 percent. Various age-dependent trends in the incidence of abnormal levels are noted. Hypogonadism as well as hyperpituitarism appear to increase in incidence with increasing age. Hyperprolactinemia, however, seems to be relatively constant in occurrence. Because of the likelihood of detecting endocrine abnormalities, a recommendation is made for routine hormonal screening of all patients complaining of impotence.

Adolescent↗
PubMed1991

Intracavernous pharmacotherapy in psychogenic impotence.

Twenty-five men with psychogenic impotence but without serious psychopathology were considered for intracavernosal therapy with papaverine hydrochloride and phentolamine mesylate. A total of 20 proved suitable and began self-injection in conjunction with sex therapy; 8 patients had return of spontaneous erections without pharmacotherapy, although one of them needs to keep the medication in his refrigerator. The other 12 patients are continuing self-injection therapy. Psychotherapy with self-injection may be helpful in the management of psychogenic erectile impotence.

Adult↗
PubMed1993

Effectiveness and safety of multidrug intracavernous therapy for vasculogenic impotence.

A four-drug vasoactive mixture (papaverine hydrochloride, prostaglandin E1, phentolamine mesylate, atropine sulfate) was used for intracavernous injection therapy in 94 patients with vasculogenic impotence as diagnosed by color Doppler sonography and dynamic infusion cavernosometry-cavernosography. At a mean follow-up of twenty months, 66 patients (70%) are using the injections with the initial dose and are satisfied; 14 patients (15%) are using the injections with a smaller dose than initially given; and 14 patients (15%) dropped intracavernous treatment. Only 4 patients (4%) were unable to achieve a sustained rigid erection during the mixture titration phase. Selected cases of vasculogenic impotence can be safely and effectively treated by the association of drugs which rely on different mechanisms of action, producing a pharmacologic synergism which enhances the overall therapeutic effect.

Alprostadil↗
PubMed1993

Nitric oxide synthase: a new diagnostic tool for neurogenic impotence.

Cavernosal biopsy specimens obtained from men undergoing penile surgery permitted determination of the diagnostic value of nitric oxide synthase in neurogenic impotence. In biopsy specimens obtained from 25 men, the presence of nitric oxide synthase (NOS), as shown by nicotinamide adenine dinucleotide phosphate (NADPH) diaphorase staining, was determined in nerve fibers, smooth muscle, and sinusoidal endothelium. Positive staining for NOS correlated significantly (p < or = 0.001) with a clinical history of cavernous nerve integrity. In comparison, staining with protein gene product (PGP 9.5), an excellent general nerve stain, lacked any degree of specificity as an indicator of nerve status. NADPH diaphorase may provide important insight into the cavernous nerve integrity of the patient. This report is the first to describe histologic features of human cavernosal tissue biopsies that will allow the direct diagnosis of neurogenic impotence owing to cavernous nerve damage.

Amino Acid Oxidoreductases↗
PubMed1993

Effect of multidose intracorporeal injection and audiovisual sexual stimulation in vasculogenic impotence.

Erections are inhibited by sympathetic stimulation. Anxiety or psychologic inhibition may produce abnormal response during impotence workup. The use of intracorporeal alpha blockers (phentolamine) and audiovisual sexual stimulation (AVSS) has been used to decrease sympathetic outflow and enhance erectile response. Thirty-three patients with suspected vasculogenic impotence were studied. They underwent pulsed Doppler ultrasound (PDUS) with multiple doses of tri-mix (mix of papaverine, phentolamine, and prostaglandin E1). AVSS was applied after maximal response to tri-mix. Seventeen patients (51.5%) responded to multidose with grade IV or V erection. When AVSS was started, 5 more patients responded, and 7 upgraded to grade V with overall response of 40 percent. AVSS can augment the in-office response to pharmacologic testing above that obtained by "maximal" pharmacologic dosing, thereby increasing the sensitivity and specificity of the test.

Alprostadil↗
PubMed1985

Sulpiride-induced hyperprolactinemia and impotence in male psychiatric outpatients.

The relationship between erectile dysfunction and sulpiride stimulatory effect on prolactin secretion was studied in 13 married male psychiatric outpatients. The patients population was comprised of 2 groups: patients with anxiety disorders resistant to minor tranquilizers who were treated with sulpiride up to 200 mg/day, and schizophrenic patients treated with sulpiride 600 mg/day. All the patients were maintained on maximal dose for a period of 3 weeks. Sexual function and blood prolactin levels were monitored once weekly. The patients who developed impotence were maintained on higher doses of sulpiride and exhibited higher prolactin levels in comparison to the potent patients. Restoration of potency was observed after reduction or discontinuation of sulpiride treatment. It is concluded that sulpiride induced impotence is associated with hyperprolactinemia.

Adult↗
PubMed1987

Apomorphine-induced penile tumescence in impotent patients--preliminary findings.

Apomorphine (Apo), a short acting dopamine (DA) receptor agonist induces penile erections in normal subjects. The erectile response to one or more doses of Apo HCl (0.25, 0.5, 0.75, 1.0 mg sc) or placebo was investigated in eight impotent subjects and penile tumescence monitored using a mercury strain gauge and strip chart recording. Four patients showed a full erection with Apo and one a partial response. Distressing side effects (nausea, sweating) were associated with non-response or partial response. Three responders to Apo were treated with low doses of the long acting DA receptor agonist, bromocriptine (2.5-3.75 mg/d po); all three showed complete recovery of erectile function within two weeks. A subgroup of impotent patients may have impaired central DA function. Testing with Apo may provide a diagnostic and predictive test to identify such patients who may respond to treatment with low doses of bromocriptine or other DA receptor agonist.

Adult↗
PubMed1989

Endorphins in male impotence: evidence for naltrexone stimulation of erectile activity in patient therapy.

In the present study we evaluated whether naltrexone administration could stimulate sexual function in 30 male patients, ages 25 to 50 years, with idiopathic impotence of at least one year's duration and not of organic etiology. The patients received naltrexone (50 mg/day) or placebo, on a random basis for two weeks. Sexual performance, expressed as the number of full coitus/week, was assessed before (time 0) and during (on days 7 and 15) each treatment. The naltrexone therapy significantly increased the number of successful coitus compared to placebo after 7 and 15 days of treatment: improvement of sexual performance was evident in 11 out of the 15 treated patients. All the patients experienced a significant increase in morning and spontaneous full penile erections/week. No significant side effects were reported. Endocrine studies revealed no significant modification of plasma LH, FSH or testosterone by naltrexone, suggesting that the positive effect of the drug on sexual behavior was exerted at a central level. A two-month follow-up, at which time patients were off treatment, erectile capacity had returned to baseline in 10 patients, while five reported complete recovery of their sexual ability. We hypothesize that an alteration in central opioid tone is present in idiopathic impotence and is involved in the impairment of sexual behavior.

Adult↗
PubMed2005

Oral androstenedione-induced impotence and severe oligospermia.

OBJECTIVE: To report a case of androstenedione (A)-induced impotence and severe oligospermia. DESIGN: Case report. SETTING: Multispecialty tertiary referral center. PATIENT(S): A 29-year-old married male recreational bodybuilder using the legal dietary supplement A in an attempt to enhance athletic performance. INTERVENTION(S): Immediate cessation of oral A, Depo-T regimen with a taper, administered during 3 months, to alleviate loss of libido and impotence. MAIN OUTCOME MEASURE(S): Resolution of symptoms and normalization of semen parameters. RESULT(S): Resolution of symptoms and normalization of semen parameters at 6 months, and successful intrauterine pregnancy achieved 1 year after initial presentation. CONCLUSION(S): Oral A has a previously unrecognized side effect, which is the potential to suppress the hypothalamic pituitary gonadal axis.

Administration, Oral↗
PubMed2000

Acute low doses of melatonin restore full sexual activity in impotent male rats.

Evidence exists that repeated injections of melatonin in rather large doses inhibit sexual performance in male rats. In contrast, systemic injection of small doses of this hormone stimulates sexual activity of normal male rats. In these experiments, systemic acute administration of melatonin in small doses (10-100 microg/kg) induced the appearance of ejaculations in impotent Wistar male rats that were selected as showing null sexual approach or showing mounts, intromissions but no ejaculations. This effect was partially abolished by the simultaneous peripheral injection of the non-selective melatonin receptor antagonist, luzindole, or by the acute administration of serotonin or of the 5HT(2A) receptor agonist, 1-(2,5-dimethoxy-4-iodophenyl)-2-aminopropane (DOI), into the amygdala or the ventral hypothalamus. These results suggest that melatonin may stimulate, in a dose-dependent manner, several copulatory parameters of male sexual behavior and may restore sexual activity in impotent animals by interacting with brain receptors, i. e. melatonin and serotonin receptors.

Amphetamines↗
PubMed1978

Penile blood pressure in the evaluation of erectile impotence.

Identification of specific etiologies of erectile impotence is hindered by a paucity of objective criteria needed to segregate organic from psychogenic varieties and to define specific organic causes. Simplified measurement of penile blood pressure was performed with a digital cuff and a portable ultrasound Doppler system for flow detection. An index relating penile-to-brachial systolic blood pressure was generated, and the results were compared in patients with impotence versus patients with normal erections. The mean indices for the two groups were significantly different (P less than 0.05). The penile-to-brachial index provides an additional diagnostic tool in the evaluation of potency, allowing us to identify those patients with decreased penile blood flow, and may be helpful in selecting patients for revascularization procedures.

Blood Pressure↗
PubMed1994

Impotence and chronic renal failure: a study of the hemodynamic pathophysiology.

A retrospective multi-institutional study was performed to document and characterize the arterial vascular disease in the hypogastric-cavernous arterial bed and/or veno-occlusive dysfunction of the corpora cavernosa in patients with end stage renal disease. We evaluated 20 impotent patients (mean age 40 +/- 9 years) with chronic renal failure using pharmaco-cavernosometry and pharmacocavernosography (4 also underwent pharmaco-arteriography). Patients were divided into groups based on the treatment (14 with renal transplantation and 6 with hemodialysis or peritoneal dialysis), as well as by history of vascular risk factors (16 with and 4 without risk factors). Of the patients 19 revealed abnormal intracavernous pressure responses to repeated intracavenous injections of vasoactive agents implying vascular disease of the penis. Cavernous artery occlusive disease was found in 78% of the patients. All patients who underwent arteriography had diffuse atherosclerotic disease of the distal penile arteries. Corporeal veno-occlusive dysfunction was found in 90% of the patients, of whom 60% had diffuse pan-cavernous leakage involving the dorsal, cavernous and crural veins, glans penis and corpus spongiosum. This renal failure-associated vascular disease of the penis was found to occur independently of the presence of known systemic atherosclerotic vascular risk factors. Patients who underwent early treatment of the uremia by renal transplantation had vasculogenic impotence only in the case of rejection of the renal transplant, suggesting that early renal transplantation may delay or prevent the development of the penile vasculopathy. The most likely pathophysiology of the vascular impairment includes renal failure-associated atherosclerosis, and renal failure-associated hypoxia changes of the contractile (smooth muscle) and structural (collagen/elastin) components of the erectile tissue. Strategies for future research and clinical therapies are suggested.

Adult↗
PubMed1993

Nitroglycerin ointment in the treatment of impotence.

Topical nitroglycerin ointment has been studied in the laboratory as a possible treatment for impotence of various etiologies. However, there is limited information on the topical administration of nitroglycerin in a natural environment allowing normal sexual function. We report 3 cases of impotence that were successfully treated with topical nitroglycerin ointment.

Administration, Cutaneous↗