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At least 883 records · Page 49Linked to original sources
PubMed1989

The role of dynamic corpora cavernosography in the management of impotence.

Sixty eight impotent men underwent corpora cavernosography and corpora cavernosal pressure measurements during saline infusion. Nineteen of the men had internal pudendal arteriograms. Correlation between the cavernosograms and saline infusion induced pressure measurements was "good" in 56/66(84%), "approximate" in 5/66(8%) and there was no correlation in 5/66(8%). Two patients were excluded for technical reasons. The spread of results and the good correlation of the two tests speaks for the accuracy of the method. It was of value in diagnosis and will be of paramount importance if veno occlusive surgery becomes a reliable method of treatment.

Adult↗
PubMed1986

Effects of bromocriptine on neuroleptic-induced amenorrhea, galactorrhea and impotence.

The effects of bromocriptine on neuroleptic-induced endocrinological disturbances (amenorrhea, galactorrhea and impotence) were investigated. Bromocriptine (5.0-7.5 mg/day) was administered to psychiatric patients receiving neuroleptics and developing hyperprolactinemia. The following results were obtained. Menses recurred in 7 of 10 patients with amenorrhea. A decrease in lactation appeared in 5 of 6 patients with galactorrhea. A significant increase in the serum levels of testosterone was observed after 8 weeks of the treatment in male patients. (N = 6). There was no remarkable deterioration in regard to the psychotic symptoms in schizophrenic patients. (N = 7). In non-schizophrenic patients (N = 9), a significant improvement was observed in regard to "somatic concern" (in Brief Psychiatric Rating Scale).

Adolescent↗
PubMed1980

Penile prostheses for the treatment of impotence.

Eighty-nine patients were treated for impotence with penile prostheses. The Small-Carrion prosthesis was used in 56 patients, the inflatable prosthesis in 27 and Pearman's prosthesis in 6 patients. The overall functional results with the Small-Carrion and inflatable prostheses were comparable.

Adult↗
PubMed1982

Impotence--the team approach to investigation and surgical treatment.

A multidisciplinary study group was established to assess impotent patients. One hundred and forty-eight patients were fully assessed and 25 potent volunteers underwent measurement of nocturnal penile tumescence (NPT). This report describes the selection process and results of surgical implantation of the American Medical Systems (AMS) inflatable and the Jonas silver-silicone prostheses.

Adult↗
PubMed1987

Experience with intracorporeal injection of papaverine and duplex ultrasound scanning for assessment of arteriogenic impotence.

We present our experience with the intracorporeal injection of papaverine and duplex sonography in the assessment of 47 patients with suspected vasculogenic impotence. Sonography and Doppler analysis were performed before and after the papaverine injection. The anatomy of the penis was easily seen. Flow in the deep arteries was obtained in most patients in both the flaccid and erect state. Patients with a good erectile response to papaverine injection had a larger increase in the inner diameter of the deep cavernosal artery than did those with a poor response. However, the percentage change in the diameter did not correlate with the degree of clinical response. Following injection, the systolic peak flow rates and diastolic minimum flow rates were higher in patients with some clinical response but only the increase in diastolic flow rates correlated in a stepwise fashion with the degree of clinical response. This technique provides a method for the objective assessment of response to intracorporeal papaverine injection. Its potential as a diagnostic test will only be determined after normal values are established. At present it appears most useful in patients responding poorly to papaverine injection by indicating the possible area of vascular impairment and the direction for further evaluation.

Adult↗
PubMed1988

Prolonged erections following intracorporeal injection of medications to overcome impotence.

We describe the management of 17 men who developed prolonged erections following the intracorporeal injection of vasoactive drugs (e.g. papaverine) for the treatment of erectile dysfunction. Twelve men who had psychogenic impotence developed prolonged erections following injection compared with 5 who had an organic aetiology. The aspiration of 20 to 50 ml of blood from the penis together with the intracorporeal injection of 1 to 2 mg metaraminol is an effective treatment of this complication.

Adult↗
PubMed1988

The value of testing for unmyelinated fibre, sensory neuropathy in diabetic impotence.

Measurement of thermal thresholds provides a means of assessing neurological deficit and in particular of recognising a neuropathic process affecting unmyelinated and small myelinated fibres of the peripheral nerve. These groups of fibres cannot be tested by nerve conduction studies but are particularly susceptible to disease in diabetes. Thresholds for thermal sensation on the sole of the foot were measured in 33 men presenting with erectile dysfunction. All 15 men with erectile dysfunction, which had been considered on clinical grounds to be neuropathic, had abnormal thermal thresholds. Diabetics with non-neuropathic erectile dysfunction had normal results. Whereas tests of unmyelinated sensory fibre function were abnormal in all those with neuropathic erectile dysfunction, electrophysiological measurement of the bulbocavernosus reflex was normal in five of nine men with diabetic neuropathic impotence.

Adult↗
PubMed1989

Deep dorsal vein arterialisation in vascular impotence.

A series of 12 patients with vasculogenic impotence (4 arterial lesions; 8 arterial and venous lesions) underwent deep dorsal vein arterialisation after pre-operative assessment by a multidisciplinary approach. Cumulative graft patency was 58% (7 of 12 patients) up to 21 months but only 4 patients developed almost normal erections. Digital angiography, with and without the intracavernous injection of papaverine, was performed during follow-up to determine the vascular physiological status. At flaccidity, the corpora cavernosa were never opacified in the absence of a venocorporeal shunt. The penile glans was always visualised. Opacification of the deep dorsal vein and the circumflex system decreased with penile rigidity, resulting from their compression between Buck's fascia and the tunica albuginea. Intracavernous pressure recorded before and after the surgical procedure showed a marked increase when a caverno-venous shunt was performed. Hypervascularisation of the glans occurred in 2 cases. The relevance of this new surgical technique and its functional mechanism are discussed.

Adult↗
PubMed1994

Microsurgical arterio-arterial and arterio-venous penile revascularization in patients with pure arteriogenic impotence.

OBJECTIVE: To restore physiological erection by performing microsurgical penile revascularization. PATIENTS AND METHODS: The records of 21 patients with pure arteriogenic impotence were reviewed. Thirteen patients with localized obstruction of the internal pudendal or common penile artery underwent a Michal II arterio-arterial penile revascularization. Eight patients with a more distal arterial obstruction underwent a penile deep dorsal vein arterialization (DDVA). The mean follow-up period was 22 months. Surgery was considered successful when the patients had a permeable anastomosis and were able to achieve satisfactory erections resulting in normal intercourse. RESULTS: Potency was restored in eight of the 13 patients who had a Michal II procedure and in five of the eight patients who had a DDVA. Under antithrombotic therapy graft occlusion occurred in four patients. CONCLUSION: Microsurgical penile revascularization restored erectile function in two-thirds of patients in this study. However, further research must be performed to reach a greater understanding of the revascularization process.

Adult↗
PubMed2005

The additive erectile recovery effect of brain-derived neurotrophic factor combined with vascular endothelial growth factor in a rat model of neurogenic impotence.

OBJECTIVE: To test the hypothesis that combined intracavernosal injection with vascular endothelial growth factor (VEGF) with adeno-associated virus-mediated brain-derived neurotrophic factor (AAV-BDNF) synergistically facilitates the neural regeneration and erectile function after cavernosal nerve injury. MATERIALS AND METHODS: Forty Sprague-Dawley male rats were randomly divided into five equal groups: eight had a sham operation while 32 had bilateral cavernosal nerve freezing followed by an immediate intracavernosal injection with either phosphate-buffered saline (PBS), VEGF, AAV-BDNF, or AAV-BDNF + VEGF. Erectile function was assessed by cavernosal nerve electrostimulation at 3 months, and samples of the major pelvic ganglia and penile tissue were evaluated histologically. RESULTS: In this animal model of impotence from nerve injury, the recovery of erectile function was greatest in those receiving AAV-BDNF + VEGF; the mean (sd) maximal intracavernosal pressure in this group was 87.2 (20.78) cmH2O, compared with 37.3 (11.39) for VEGF alone and 49.8 (29.58) for AAV-BDNF alone. No erectile dysfunction was identified in the sham group, with a pressure of 100.7 (22.70) cmH2O, while all treatment groups significantly outperformed the PBS (control) group, at 29.3 (13.52) cmH2O. Furthermore, all animals receiving monotherapy or combined treatment had more NADPH-diaphorase-positive nerve fibres than controls but less than in the sham group. CONCLUSION: Bilateral cavernosal nerve freezing causes erectile dysfunction with accompanying neurological changes. Intracavernosal injection with either VEGF or AAV-BDNF alone enhances nerve regeneration, with combined therapy (VEGF and AAV-BDNF) promoting neural and erectile recovery additively.

Adenoviridae↗
PubMed1992

Staphylococcal septicaemia complicating intracavernosal autoinjection therapy for impotence in a man with diabetes.

Intracavernosal injection of vasoactive drugs is a safe, effective, and commonly used treatment for impotence in diabetic men. In prospective studies infection has rarely occurred. We report a case of life-threatening Staphylococcal septicaemia complicating this treatment in a 61-year-old man with Type 2 diabetes, probably due to a combination of an unsterile technique and drug-induced priapism. Infection is a potential risk in diabetic men using intracavernosal injection therapy and those offered it should be informed of the importance of a scrupulous sterile technique and the need to seek urgent medical help for decompression if an erection persists for more than 4-6 h.

Bacteremia↗
PubMed1998

Moxisylyte: a review of its pharmacodynamic and pharmacokinetic properties, and its therapeutic use in impotence.

Moxisylyte is a competitive noradrenaline antagonist, acting preferentially on post-synaptic alpha-1 adrenoceptors. It was introduced more than thirty years ago for the treatment of cerebro-vascular disorders and shown more recently effective in the urological field due to its ability to modulate the urethral pressure. Renewal of interest in this drug has been observed in recent years since the demonstration of the possibilities of vasoactive drugs in evaluation and treatment of erectile dysfunctions. Moxisylyte is a prodrug, rapidly transformed into an active metabolite in plasma (Deacetylmoxisylyte or DAM). Elimination of the active metabolite occurs by N-demethylation, sulpho- and glucuroconjugation. The N-demethylated metabolite is sulphoconjugated only. Urine is the main route of excretion. The metabolites of moxisylyte can be determined in biological fluids by various methods using high-performance liquid chromatography. Their pharmacokinetics is dependent on the route of administration. By the oral route, the concentrations of the active metabolite are low, and the glucuroconide of DAM predominates over the sulphates. After intravenous and intracavernous injection, the active metabolite is proportionally higher, the two sulphates are equivalent and in larger amounts than the glucuronide. In the treatment of impotence, intracavernous injection of moxisylyte at 10, 20 or 30 mg can induce an erection adequate for intercourse in most of the patients. Compared to inducing agents such as papaverine and prostaglandin E1, moxisylyte must be considered as a facilitator of male erection, its interest lying in the low rate of adverse effects, either general or local.

Absorption↗
PubMed1978

Phobic partner-specific impotence in women.

Functional coital impotence is not exclusive to men. It also occurs in two groups of women: those suffering from vaginismus and those with depressive episodes that give rise to a partner-specific sexual phobia. The latter syndrome is by no means uncommon, yet it has not so far attracted the attention it deserves. This neglect may be largely due to the emotional complications which ensue from it and camouflage its depressive-phobic background. It can be amenable to psychotherapeutic measures combined with antidepressant medication.

Depression↗
PubMed1990

Screening impotence by home nocturnal tumescence self-monitoring.

Twenty subjects complaining of impotence were assessed using nocturnal penile tumescence (NPT), neurological, vascular and hormonal analysis. Subjects undertook NPT in both home and hospital environments: 10 hospital first and 10 home first. There were high levels of agreement between diagnosis using NPT in the two conditions and diagnosis from the physiological tests. There was a high correlation of frequency of erections between the home and hospital conditions, together with a high consecutive night reliability when using the monitor in the home condition (r = .94, p = .001).

Diagnosis, Differential↗
PubMed2006

Enhanced thromboxane receptor-mediated responses and impaired endothelium-dependent relaxation in human corpus cavernosum from diabetic impotent men: role of protein kinase C activity.

We have evaluated the influence of protein kinase C (PKC) activity on penile smooth muscle tone in tissues from diabetic and nondiabetic men with erectile dysfunction. Human corpus cavernosum (HCC) strips were obtained from impotent diabetic and nondiabetic men at the time of penile prosthesis implantation and studied in organ chambers. Contractility responses to a prostanoid precursor, to prostanoids, and to the endothelium-dependent vasodilator acetylcholine were studied. Arachidonic acid (AA; 100 microM) caused cyclooxygenase-dependent relaxation of HCC. This relaxation was impaired in diabetic tissues and normalized by blocking thromboxane (TP) receptors with 20 nM [1S-[1alpha,2alpha(Z),3alpha,4alpha]]-7-[3-[[2-[(phenylamino)carbonyl]hydrazino]methyl]-7-oxabicyclo[2.2.1]hept-2-yl]-5-heptenoic acid (SQ29548). Diabetes did not affect prostaglandin (PG)E(1)-induced relaxation, but it reduced relaxation induced by the PGE(1) metabolite PGE(0). This effect was related to an interaction of PGE(0) with TP receptors. Diabetic tissues had reduced endothelium-dependent relaxation, which was partially improved by SQ29548 and completely normalized by the PKC inhibitor 3-[1-[3-(dimethylaminopropyl]-1H-indol-3-yl]-4-(1H-indol-3-yl)-1H-pyrrole-2,5-dione monohydrochloride (GF109203X; 1 microM). In HCC from nondiabetic patients, treatment with the PKC activator phorbol-12,13-dibutyrate (0.3 microM) significantly attenuated endothelium-dependent relaxation, an effect prevented by coadministration of GF109203X. Tissues from diabetic patients had enhanced sensitivity to the contractile effects of the TP receptor agonist 9,11-dideoxy-9alpha,11alpha-epoxymethano PGF(2alpha) (U46619) (EC(50) = 0.65 +/- 0.42 and 6.01 +/- 2.28 nM in diabetic and nondiabetic patients, respectively). Inhibition of PKC with 1 microM GF109203X, prevented diabetes-induced hypersensitivity to U46619-induced contractions (EC(50) = 8.55 +/- 3.12 microM). Overactivity of PKC in diabetes is responsible for enhanced contraction and reduced endothelium-dependent relaxation of HCC smooth muscle. Such alterations can result in erectile dysfunction.

Alprostadil↗
PubMed1994

Endocrine assessment of impotence--pitfalls of measuring serum testosterone without sex-hormone-binding globulin.

The pitfalls of measuring only total serum testosterone are illustrated by a 52 year old man whose hyperprolactinaemia was associated with normal total serum testosterone but a raised sex-hormone-binding globulin, giving a low free testosterone. Prolactin suppression with bromocriptine normalized sex-hormone-binding globulin and free testosterone, and restored potency and energy after 30 years of impotence and tiredness.

Bromocriptine↗
PubMed1984

Sex hormone suppression and sexual impotence in hypoxic pulmonary fibrosis.

Eight men with hypoxia associated with idiopathic pulmonary fibrosis were studied. Serum testosterone concentrations were low in two subjects and fell to subnormal levels in two others as the clinical condition and arterial oxygen tension deteriorated. There was a significant correlation between serum testosterone concentrations and arterial oxygen tensions (p less than 0.05). Three patients showed evidence of suppression of luteinising hormone secretion at the pituitary level. Only occasional abnormalities of thyroid and prolactin concentrations were noted. Most of the men suffered from organic sexual impotence, which is considered to be due at least in part to endocrine disturbance. These findings are similar to observations in patients with hypoxic chronic obstructive airways disease and support the hypothesis that hypoxia of lung disease suppresses the hypothalamo-pituitary-testicular axis.

Adult↗