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PubMed1980

Alteration of the penile corpora in patients with erectile impotence.

We measured the content of the two principal neurotransmitters of the autonomic nervous system from the erectile tissue of four men with normal erection and 38 men impotent as a result of injury or disease. In the former the norepinephrine content was 812 +/- 82.6 (SE) pg per mg of wet weight; In the latter, statistically significant reductions of norepinephrine were found with the greatest decrease occurring with insulin-dependent diabetes mellitus. Neither choline acetyltransferase activity nor morphologic alterations of the nerve fibers of erectile tissue were observed in either group. Our findings suggest that the sympathetic nervous system is an integral component of human erection and that a functional alteration of the corporal nerve fibers occurs with several diseases associated with impotence.

Choline O-Acetyltransferase↗
PubMed1984

[Clinical experience of bromazepam for psychogenic impotence patients].

A clinical trial was performed with the tranquilizer Bromazepam on 39 patients undergoing diagnosis of psychogenic impotence, and the drug effect was evaluated according to the criteria based on our protocol. The protocol specifies 8 tests (1 for libido, 4 for erection, 2 for ejaculation, 1 for orgasm) which are scored according to an arbitrary logarithmic scoring system. At the end of the study the points made in the 8 tests were added to obtain the total score as the basis for evaluation of the overall drug effect. After treatment all tests showed an improvement, and the improvement in erection during masturbation, reflective erection, and condition of ejaculation was statistically significant. The total score also improved from 16.77 +/- 2.62 (mean +/- S.D.) before treatment to 11.42 +/- 1.96 after treatment, and the change was again statistically significant (P less than 0.05). The rate of satisfaction as a subjective symptom of improvement also increased from 25.38 +/- 4.40% to 39.10 +/- 4.53%. The results of the present study provide evidence to indicate that Bromazepam is beneficial for psychogenic impotence.

Administration, Oral↗
PubMedDate not supplied

[Surgery of impotency (author's transl)].

Psychic disorders may sometimes explain the impossibility of erection. Organic causes of impotency must not go unrecognized though, because they are numerous: lesions of the cavernous bodies, arterial occlusions and deficiencies of innervation. The implantation of silicone prostheses in the cavernous bodies insures the erection and makes possible a normal sexual activity: the orgasm and the ejaculation may reappear even after they have disappeared for many years. This operation was realized in sixteen patients according to the technique of Small and Carrion. Postoperative hospitalization is usually of 24 hours. All patients resumed a normal sexual activity. Our earliest observation occurred three years ago. Up to now there were no cases of infection, or rejection. The implantation of silicone prostheses in the cavernous bodies constitutes an important step in the treatment of organic impotency.

Erectile Dysfunction↗
PubMedDate not supplied

[There is no relationship between endogenous insulin release, release during OGTT and androgenic function in patients suffering from psychogenic impotence (author's transl)].

We have studied androgenic function (basal testosterone, DHT, E2, androsterone, etiocholanolone, and dynamic response to TRH (hPr) and LRH (LH, FSH) and insulin induced release during O.G.T.T. in 35 patients suffering from "psychogenic impotence" and glucose intolerance. We found no correlation between androgenic parameters and insulin release thus affirming the hypothesis of an antagonism between the two systems as postulated previously by others. However we found a positive significant correlation between basal prolactin level and the testosterone/dihydrotestosterone ratio together with a slight increase of basal prolactin and E2 and a decrease of DHT in the patients group compared to non impotent non glucose intolerant group. Our results suggest that a moderate hyperprolactinemia, whose origin is discussed, could participate in the pathogenesis of sexual disturbances in some patients with glucose tolerance.

3-Oxo-5-alpha-Steroid 4-Dehydrogenase↗
PubMedDate not supplied

Clinical and hormonal effects of testosterone undecanoate (TU) in male sexual impotence.

Eight patients with sexual impotence, fertile and clinically normal, average age of 41, were given TU orally for 46 days, in a dose of 120 mg/day. The mean (+/- SE) plasma FSH, LH and testosterone levels were significantly lower than in a group of 20 healthy adult men, average age 36. In the course of treatment there were no significant changes of mean serum FSH and LH concentrations, while circulating testosterone levels rose significantly to normal levels throughout the whole study. Almost all patients reported a marked increase in sexual and mental activities. The identical pattern as in hypogonadotrophic hypogonadal patients is considered and a possible hypothalamo-hypophyseal deficiency in the pathogenesis of sexual impotence in all 8 subjects is envisaged.

Adult↗
PubMed1982

[The significance of dyshormonal changes in the hypothalamo-hypophyseal-gonadal system in the diagnosis of infertility and impotence in the male].

On 17 male patients with infertility and 13 with impotence hormonal changes in the hypothalamus-hypophyse-testiculary system have been investigated by radioimmunoassay. On patients with infertility low plasmatestosteron and increased LH and FSH levels were found. 2.5 to 3 fold increase of plasmatestosteron levels were found on patients with impotence.

Adult↗
PubMed1980

Synthetic luteinizing hormone-releasing hormone in impotent male diabetics.

We compared the effect of luteinizing hormone-releasing hormone (LH-RH) 500 micrograms 8-hourly and placebo on sexual function in impotent diabetic males. These patients had no obvious vascular or neurological disease and no major psychological disorders to account for their impotence. Basal serum testosterone concentrations were normal in all. Five patients had elevated basal gonadotropin concentrations and/or exaggerated gonadotropin responses to LH-RH. During the first week of the LH-RH treatment there was a significant rise in LH and follicle-stimulating hormone (FSH) concentrations. The LH levels remained elevated throughout the second week of treatment, whereas the FSH returned to pretreatment values. There was no change in hormone concentration during placebo therapy. Clinical responses to treatment were assessed by a self-evaluating questionnaire relating to (i) sexual function and libido; (ii) erectile potency; and (iii) general well-being. There was no significant change within each category, but taken together a significant improvement was found with both LH-RH and placebo treatment. There was no difference between the two forms of treatment.

Adult↗
PubMed1980

[Study of GH in patients suffering from sexual impotence and abnormal glucose tolerance test (author's transl)].

The correlation between dopamine-serotonin systems and sexual behaviour and the influence of these two amines on GH secretion is well known. We evaluated GH responses (maximum increase (delta) after OGTT and mean increase (delta M) after insulin test) in a group of 32 males suffering from erective impotence with impotence with abnormal reaction to a glucose tolerance test. Results were compared with those obtained in a group of 13 normal controls. No significant difference in basal values and dynamic responses between the two groups was present. Our data suggest that GH doesn't decrease the tolerance to glucose in these patients. The abnormal values observed during a glucose tolerance test may be due to some agent involved in the interactions between limbic system, ventral lateral and ventral medial hypothalamic nuclei and dopamine-serotonin systems. No influence by this system on GH secretion is evident.

Adult↗
PubMed1978

Evaluation and treatment of patients with impotence.

Impotence is a common problem of adult males. Thorough history from both partners, physical examination, and laboratory work uncover a small minority who are suffering from an organic cause. The majority of such patients have a psychological basis for the condition. In the absence of demonstrated organic disease, psychiatric consultation is indicated. Surgery is helpful in erectile impotence.

Erectile Dysfunction↗
PubMed1982

Experience with penile prostheses in the treatment of impotence in diabetic men.

Increasing use of penile prostheses to treat impotence in diabetic men warrants a detailed assessment of functional and subjective outcomes within this group. This study uses record review and patient-partner questionnaire techniques to examine this population and evaluate postoperative satisfaction in terms of changes in patterns of sexual activity, health status, and complication rates. The satisfaction rates among patients and partners were 81% and 83%, respectively. Frequency of sexual activity was increased, and physical enjoyment was improved among satisfied recipients. Most postoperative complications were treatable and led to dissatisfaction only if they were irreparable. Most prostheses are therefore being used successfully. We recommend that impotent diabetic men be informed of the availability of prosthetic implants.

Adult↗
PubMed1982

A comparison of two techniques for the detection of the vasculogenic component of impotence.

Eighty-six patients have been evaluated in the vascular laboratory with regard to vasculogenic impotence. Doppler ultrasound and a new method, photoplethysmography, have been used alone and in combination, compared and correlated with the results of psychiatric therapy. Doppler ultrasound and the photoplethysmographic techniques give almost identical results apart from the zero reading on the Doppler recordings which correlates poorly with the results of psychotherapy and photoplethysmographic findings. The photoplethysmographic technique is quicker, more esthetically acceptable and is, therefore, the method of choice for the assessment of the vasculogenic component of impotence.

Blood Pressure↗
PubMed1980

[Vascular investigation of impotence (author's transl)].

Approximately 25% of patients with impotence have erectile dysfunction of vascular origin, which requires systematic investigation in patients under 60 years of age because of the possibility of surgical treatment. Diagnosis is based on clinical findings, confirmed by two tests that are simple to conduct in ambulatory patients, doppler and plethymography. Arteriography of the sexual organs enables precise definition of the lesions, and surgery is indicated when there is strong clinical evidence, no other cause for the lesions can be found, and operative correction appears possible. Many unknown factors still exist in relation to the physiopathology of impotence of valvular origin. Current-research is directed towards detection and possible treatment of disorders of venous origin.

Angiography↗
PubMedDate not supplied

[Evidence of different psychological profiles in sexual impotence (author's transl)].

The homogeneity of personality in patients suffering from psychogenic impotency has never been tested. In order 1. to test the homogeneity of the population and 2. to delineate putative prognostic scores, the authors have applied inverse factorial analysis to MMPI and Rorschach performed in a group of 100 patient suffering from "psychogenic impotence". The results obtained evidenced an heterogeneity in the group, subgroups may differ as far as prognostic is concerned.

Adult↗
PubMed1981

[The role of penile Doppler sonography in impotent diabetics].

Penile systolic pressure has been evaluated by the Doppler-sonographic method in 15 diabetic patients suffering from erectile impotence. Urodynamic tests have also been carried out in some patients for a diagnosis of neurological impotence. The results obtained show the possibility of a double or sole origin (neurogenic or vascular, or both) in the pathogenesis of this symptom in diabetic subjects.

Adult↗
PubMed1980

Transient impotence from positioning on the fracture table.

A case of transient impotence caused by pressure from the perineal post of the fracture table is reported. The anatomic position of the pudendal and cavernous nerves appears to account for the impotence. The use of a foam-rubber fitting for the perineal post is recommended.

Adult↗
PubMed1980

Previously unrecognized diabetes mellitus in sexually impotent men.

Three-hour oral glucose tolerance tests (GTTs) were performed for 58 men with secondary impotence (SI), 63 with normal sexual function (NL), and 69 with premature ejaculation (PRE). All were apparently nondiabetic. Diagnoses of diabetes and impaired glucose tolerance were based on serum glucose levels during GTT as recently defined by the National Diabetes Data Group. Covariance analysis corrected for weight and age differences. Mean glucose levels in patients with SI were significantly higher at one and two hours after glucose ingestion than in the other groups. Seven patients with SI (12.1%) were found to have diabetes. The three groups did not differ notably in frequency of impaired glucose tolerance. Inorganic serum phosphate levels were lower for the SI group. The high frequency of diabetes in subjects with SI who have no diabetic symptoms (12.1%) suggests that localized neuropathy or penile ischemia may produce impotence in otherwise asymptomatic patients.

Adult↗
PubMed1980

[The surgical treatment of impotence of arterial origin (author's transl)].

26 subjects underwent surgery for impotence of arterial origin between January, 1976 and January, 1979. The mean age of these patients was 49.6 years. The post-operative course was followed up with a mean period of 19.6 months. The 3 epigastrico-cavernous bypasses gave no good results beyond the third month. The best results were seen in lesions situated around the ostium of the internal iliac (9 cases out of 10). The treatment of extensive aorto-iliac lesions in arterial impotence gave satisfactory results in 9 out of 13 cases of the series.

Adult↗
PubMed1980

[Investigation and surgical treatment of vasculogenic impotency (author's transl)].

Vasculogenic impotency does exist. Series of 45 operated cases with at least 6 month follow up give the main points of diagnosis and surgical new methods. Organic impotency is assessed by permanent leakage of morning erection, and monitoring of nocturnal penile tumescence (P.E.N.). Arterial insufficiency is present when penile pressure index (I.P.P.) is below 0,95 and Doppler penile notation up to 5 (N.D.P.). Selective hypogastric arteriography shows the site and importance of lesions. Venous incompetence is explored by cavernosography and passive erection output studies. 45 patients experienced 54 vascular procedures with 60% good results at 6 months.

Adult↗