Advances in urogenital plastic surgical tissue transfer techniques have enabled urethral reconstruction surgery to become the new gold-standard for treatment of refractory urethral stricture disease. Questions remain, however, regarding the long-term implications on sexual function after major genital reconstructive surgery. In this article, we review the pathologic features of urethral stricture disease and urologic trauma that may affect erectile function (EF) and assess the impact of various specific contemporary urethroplasty surgical techniques on male sexual function.
Reflex control of cardiovascular function is paramount in maintaining homeostasis both before and after exercise. We investigated the influence of posture on arterial baroreflex function both before and after prolonged moderate to high intensity exercise.
9 healthy subjects (1 female) aged 24.4 years (±1.16) volunteered for protocol 1 of the study and 13 healthy subjects (3 female) aged 25.5 years (±0.88) volunteered for protocol 2. Each subject underwent graded exercise test either upright (UR) (protocol 1) or semi‐recumbent (SR) (protocol 2). During both protocols 1 and 2 neck pressure/neck suction protocols were performed at rest, exercising HRs of 120 and 150 bpm, and recovery. Reflex data for HR and MAP were analyzed and baroreflex curves were calculated. Repeated measure ANOVAs was performed and Neuman‐Keuls post hoc analysis was used when differences were detected. Significance was set at P<0.05.
Significant differences were identified in operating point values of HR between SR and UR at rest (P<0.001), and between rest and recovery in both SR and UR (p<0.001). Differences were also identified in Carotid‐cardiac baroreflex response range and maximum gain between and within all conditions (p<0.05).
Differences in the neural reflexive control of HR at rest and during recovery are related to postural changes in cardiopulmonary loading.
Grant Funding Source: Supported by TACSM SRDA
Increases in exercise intensity are known to reset, in an upward and rightward direction, the arterial baroreflex (ABR) control of heart rate (HR) and mean arterial pressure (MAP). ABR function during recovery from exercise has not been extensively studied and therefore is unreported in the literature. We hypothesized that carotid baroreflex (CBR) function curves would recover with a trend opposite to the original intensity related resetting following exercise. To test this hypothesis, healthy young subjects performed cycling exercise at two workloads to establish HRs of 120 and 150 bpm. CBR function curves were collected using the neck pressure/neck suction technique. An increase in HR during recovery vs. rest (p=0.032) was recorded in all subjects without a change in MAP. From rest to recovery there were significant increases in the response range (RR) of HR (p=0.029) and the sensitivity or gain of the ABR function curves (p=0.036). The increase in HR without an increase in MAP was expected, but the RR increase during recovery due to an increase in threshold without a concomitant increase in saturation point was not. It is concluded that vagal control of HR during recovery from exercise is increased without a change in the CBR control of blood pressure.Supported by a TACSM SRDA.
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