Functional Responses of Isolated Human Seminal Vesicle Tissue to Selective Phosphodiesterase Inhibitors

Ückert, Stefan; Bazrafshan, Siamak; Scheller, Friedemann; Mayer, Marcel; Jonas, Udo; Stief, Christian G.

doi:10.1016/j.urology.2007.02.049

Cited by 29 publications

(29 citation statements)

References 19 publications

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“…21 Some authors have shown that NO decreases the central sympathetic output to the periphery 22 through a cGMP-dependent mechanism or through interactions with other neurotransmitters. 23 Many lines of evidence support the presence and activity of the NO/cyclic guanosine monophosphate (cGMP) and NO/cyclic adenosine monophosphate (cAMP) signaling pathways in the seminal vesicle (SV), 24 smooth muscles, prostate and urethra. Thus, the peripheral effects of PDE5i have been ascribed to the capability to retard the ejaculatory response due to modulation of the contraction of SV smooth muscle.…”

Section: Discussionmentioning

confidence: 99%

Effects of vardenafil administration on intravaginal ejaculatory latency time in men with lifelong premature ejaculation

et al. 2009

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Premature ejaculation (PE) is thought to be the most common male sexual dysfunction; however, the prevalence of lifelong (LL)-PE is relatively low. The aim of this study was to investigate the effects of on-demand vardenafil (10 mg) to modify the intravaginal ejaculatory latency time (IELT) in men with LL-PE without erectile dysfunction. Forty-two men (18-35 years) were enrolled in a 16-week, double-blind, placebo-controlled, cross-over study. Primary end point was the modification from baseline of IELT assessed by stopwatch technique; secondary end points were post-ejaculatory refractory time (PERT) and variations of scores at the Index of Premature Ejaculation questionnaire. The changes in geometric mean IELT were superior after taking vardenafil (0.6±0.3 vs 4.5 ± 1.1 min, Po0.01), compared with placebo (0.7 ± 0.3 vs 0.9 ± 1.0 min, ns). PERT dropped significantly after vardenafil (16.7 ± 2.0 vs 4.3 ± 0.9 min, Po0.001), compared with placebo (15.3±2.2 vs 15.8±2.3 min). Patients who took vardenafil (vs placebo) reported significantly (Po0.01) increased ejaculatory control (6±2 vs 16±2), improved overall sexual satisfaction (7±2 vs 15 ± 1) and distress (4 ± 1 vs 8 ± 1) scores, respectively. Multiple regression analysis (r 2 ¼ 0.86) for IELT by the number of attempts at sexual intercourse showed significant differences between the slopes of lines for placebo and vardenafil (Po0.0001). The most common adverse events for vardenafil (vs placebo) were headache (10 vs 3%), flushing (12 vs 0%) and dyspepsia (10 vs 0%), which tended to disappear over the time. In conclusion, in our study, vardenafil increased IELT and reduced PERT in men with LL-PE. Besides, improvements in confidence, perception of ejaculatory control and overall sexual satisfaction were reported.

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Section: Discussionmentioning

confidence: 99%

Effects of vardenafil administration on intravaginal ejaculatory latency time in men with lifelong premature ejaculation

et al. 2009

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“…Several studies on the use of PDE5i data for the treatment of DN have been published (Wang et al, 2011;Patil et al, 2004;Ali & Rakkah, 2007;Kamenov, 2011); the effects of these molecules on some functional aspects of the SV have been described , 2011;Orhan et al, 2006;Uckert et al, 2007;Gajar et al, 2007;Uckert et al, 2009;Birowo et al, 2010). Moreover, there are some data on the effects of PDE5i administration on sperm parameters (Hellstrom et al, 2008;Pomara et al, 2007).…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, evidence is accumulating that type 5 phosphodiesterase inhibitors (PDE5i) may be used for the treatment of DN (Wang et al, 2011;Patil et al, 2004;Ali & Rakkah, 2007;Kamenov, 2011) and that these molecules can modify some functional features in the SV (Ü ckert et al, 2011;Orhan et al, 2006;Uckert et al, 2007;Gajar et al, 2007;Uckert et al, 2009;Birowo et al, 2010). Therefore, the aim of this study was to investigate possible changes in the ultrasound (US) characteristics of the SV of infertile patients with DM and DN, after prolonged administration of tadalafil, a specific PDE5i.…”

Section: Introductionmentioning

confidence: 99%

Seminal vesicles and diabetic neuropathy: ultrasound evaluation after prolonged treatment with a selective phosphodiesterase‐5 inhibitor

et al. 2012

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SUMMARYWe have previously reported that infertile patients with diabetes mellitus (DM) have a particular ultrasound features of the seminal vesicles (SV) characterized by higher fundus-to-body ratio and lower pre-and post-ejaculatory difference in body antero-posterior diameter (APD). Based on these premises the aim of the present study was to investigate possible ultrasound SV changes in infertile patients with DM and diabetic neuropathy (DN), after prolonged administration of tadalafil (TAD) (a specific phosphodiesterase-5 inhibitor). To accomplish this, 20 infertile patients with symptomatic DN and erectile dysfunction were selected and arbitrarily divided into two groups which were assigned to: daily administration of 5 mg TAD for 3 months (Group A) (n = 10) and administration of placebo (Group B) (n = 10). All patients underwent to scrotal and prostate-vesicular transrectal ultrasound evaluation and semen analysis (Laboratory Manual for the Examination and Processing of Human Semen, WHO, 2010) before and after treatment. The following SV US parameters were recorded: (i) body APD; (ii) fundus APD; (iii) parietal thickness of the right and left SVs; and (iv) number of polycyclic areas within both SVs. We then calculated the following parameters: (i) fundus/body (F/B) ratio; (ii) difference of the parietal thickness between the right and the left SV and (iii) pre-and post-ejaculatory APD difference. In addition, we also evaluated the SV ejection fraction. Group A patients showed a significant reduction in F/B ratio and higher pre-and post-ejaculatory body SV APD difference compared with baseline or Group B after 3 months. These patients showed also a significant increase in SV ejection fraction and a significant improvement of the total sperm count, progressive motility, seminal levels of fructose, leucocytes and ejaculate volume. In conclusion, these results suggest that infertile DM patients with DN and erectile dysfunction had an improvement of ultrasound features suggestive of diabetic neuropathy after daily treatment with low doses of TAD.

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“…Because of their central roles in smooth muscle relaxation and tone regulation and success of PDE5i or the treatment of ED, the PDEs have also become an attractive target for PE drug development. The rationale for targeting PDEi for PE is based on the presence of PDE5 mRNA in human vas deferens and prostate (Mancina et al, 2005;Uckert et al, 2006), and the fact that PDE5 inhibitors can reverse adrenergic tone in human vas deferens and seminal vesicle (Medina et al, 2000;Uckert et al, 2007).…”

Section: Pde5 Inhibitors (Pde5i)mentioning

confidence: 99%

The characterization, current medications, and promising therapeutics targets for premature ejaculation

Gür

Sikka

2015

Andrology

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SUMMARYPremature ejaculation (PE) is the most prevalent male sexual dysfunction. This is associated with negative personal and interpersonal psychological outcomes. The pharmacologic treatment of PE includes the use of antidepressants, local anesthetic agents, and phosphodiesterase type 5 inhibitors. While numerous treatments can control PE, only antidepressants and topical anesthetic creams and sprays have recently been shown to be more effective. This review focuses on the physiology and pharmacology of ejaculation, the pathophysiology of PE and the most effective pharmacological treatment of PE. Pharmacotherapy of PE with off-label shortacting selective serotonin reuptake inhibitors (SSRIs) is common, effective, and safe. Dapoxetine, a SSRI with a short half-life, has been recently evaluated for the treatment of PE by several countries and results are promising. In clinical practice, follow-up side effects are an important part of the management strategy for PE. The understanding of etiology, pathophysiology, and treatment modalities of PE would be beneficial to clinician in helping patients with this disappointing sexual problem.

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Functional Responses of Isolated Human Seminal Vesicle Tissue to Selective Phosphodiesterase Inhibitors

Cited by 29 publications

References 19 publications

Effects of vardenafil administration on intravaginal ejaculatory latency time in men with lifelong premature ejaculation

Effects of vardenafil administration on intravaginal ejaculatory latency time in men with lifelong premature ejaculation

Seminal vesicles and diabetic neuropathy: ultrasound evaluation after prolonged treatment with a selective phosphodiesterase‐5 inhibitor

The characterization, current medications, and promising therapeutics targets for premature ejaculation

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