Lower urinary tract symptoms and erectile dysfunction: Epidemiology and treatment in the aging man

Russell, Shane T.; McVary, Kevin T.

doi:10.1007/s11934-005-0040-3

Cited by 16 publications

(10 citation statements)

References 57 publications

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“…Similarly, in 2003, Braun et al reported a strong association between LUTS and ED in a German cohort of 4489 men [34]. The coexistence of ED and LUTS may indicate that BMI is implemented in LUTS pathogenesis [17,19,37,38].…”

Section: Discussionmentioning

confidence: 99%

Body Mass Index and its Association with Genitourinary Disorders in Men Undergoing Prostate Cancer Screening

Bhojani

Perrotte

Hutterer

et al. 2008

The Journal of Sexual Medicine

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Introduction Elevated body mass index (BMI) may predispose to several pelvic pathologies. Aims We tested the association between BMI and five end points, namely, (i) erectile dysfunction (ED); (ii) lower urinary tract symptoms (LUTS); (iii) chronic prostatitis-associated pain (CPP); and ejaculatory dysfunction that is subdivided between (iv) pain/discomfort on ejaculation; and (v) subjectively decreased ejaculate volume. Methods Age, height, and weight were prospectively recorded in a cohort of 590 consecutive healthy men undergoing prostate cancer screening. Continuously coded and categorized BMI (World Health Organization classification) were studied. Main Outcome Measures Age-adjusted analyses relied on logistic and linear regression models, according to data type. Results The average age was 54.1 years (range 30–83). Of all, 296 were overweight (50.2%, BMI 25–29.9 kg/m2) and 85 were obese (14.4%, BMI ≥ 30 kg/m2). After age adjustment, elevated continuously coded BMI (P < 0.001) and elevated categorized BMI (P = 0.01) were associated with worse erectile function. Conversely, after age adjustment, elevated continuously coded BMI (P = 0.02) and elevated categorized BMI (P = 0.05) were associated with a lower rate of subjectively decreased ejaculate volume. Finally, after age adjustment, elevated categorically coded BMI was related to lower rates of CPP (P < 0.001) and to a lower rate of pain/discomfort on ejaculation (P = 0.03). Conclusions In men undergoing prostate cancer screening, the effect of BMI on the five end points is not invariably detrimental. Elevated BMI may predispose to ED, but may also decrease the rate of pain/discomfort on ejaculation and may lower the reported rate of subjectively decreased ejaculate volume. Finally, it appeared to have no effect on LUTS.

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Section: Discussionmentioning

confidence: 99%

Body Mass Index and its Association with Genitourinary Disorders in Men Undergoing Prostate Cancer Screening

Bhojani

Perrotte

Hutterer

et al. 2008

The Journal of Sexual Medicine

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“…3 This is presumably due to an inadequate activation of neuronal nitric oxide synthase (nNOS) and subsequent defective production of nitric oxide (NO). 4 Decreased NO bioavailability impairs vasodilation and enhances formation of reactive oxygen species (ROS) that can cause tissue damage.…”

Section: Pathogenesis Of Edmentioning

confidence: 99%

Emerging gene and stem cell therapies for the treatment of erectile dysfunction

2010

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Erectile dysfunction is a prevalent condition in all parts of the world and leads to significant morbidity and distress, not just for men but for their partners. Unfortunately, very few currently available treatments ameliorate underlying causes of the disorder and “cure” the disease state. Much recent effort has been focused on the development of gene and cell based approaches to rectify the molecular and tissue defects responsible for ED in human men. Gene therapy has been investigated in animal models for well over a decade as a modality by which to restore normal function to the penis; as of this time, however, only one human trial has been published in the peer reviewed literature. Stem cell therapy has been a topic of interest in more recent years although there are currently very few published reports in animal models and none in human men. In this review, we will briefly review the current literature on gene and stem cell based therapies and briefly speculate on direction for future research.

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“…Since aging is one of the main risk factors for erectile dysfunction, most men during their lifetime will at some time be afflicted with this condition [1][2][3]. It is becoming increasingly apparent that the main culprit for erectile dysfunction in the majority of patients is corporal venoocclusive dysfunction (CVOD) [4,5].…”

Section: Introductionmentioning

confidence: 99%

Long-Term Continuous Treatment with Sildenafil Ameliorates Aging-Related Erectile Dysfunction and the Underlying Corporal Fibrosis in the Rat1

Ferrini

Kovanecz

Sanchez

et al. 2007

Biology of Reproduction

108

140

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Aging-related erectile dysfunction is characterized by a loss of smooth muscle cells (SMCs) and fibrosis in the corpora cavernosa, and functionally by corporal veno-occlusive dysfunction (CVOD). Phosphodiesterase 5 (PDE5A) inhibitors, in part via upregulating inducible nitric oxide synthase (NOS2A), have antifibrotic properties in penile tissues. We aimed to determine whether in the aged rat the chronic long-term treatment with sildenafil ameliorates corporal SMC loss and fibrosis, stimulates NOS2A induction, and corrects the associated CVOD. Aged male rats (20 mo old) received sildenafil in their drinking water (20 mg/kg per day) or plain water for 45 days, and untreated young rats (5 mo old) served as controls (n = 8 per group). CVOD was assessed by dynamic infusion cavernosometry (DIC). Collagen:SMC (Masson trichrome) and collagen III:I (picrosirius red) ratios, SMC content (alpha-smooth muscle actin [ACTA2]), cell proliferation (proliferating nuclear antigen [PCNA]), apoptotic death (TUNEL), and NOS2A induction were measured by histochemistry and immunohistochemistry followed by quantitative image analysis. Collagen content was determined by hydroxyproline assay, and transforming growth factor beta-1 (TGFB1); xanthine oxidoreductase (XDH); ACTA2; NOS2A; and the Rho kinase inhibitor protein tyrosine phosphatase, nonreceptor type 11 (PTPN11), and activator, VAV, were measured by quantitative Western blot. In the aged rats treated with sildenafil, the erectile response by DIC was normalized, and the corporal SMC:collagen ratio and SMC number were increased. In addition, sildenafil reduced the corporal collagen content without affecting the collagen III:I ratio, increased the PCNA:apoptosis ratio, and stimulated NOS2A induction, although there was no effect on XDH, TGFB1, PTPN11, or VAV levels. These data show that long-term PDE5A treatment corrected CVOD in the aged rat and partially reversed the aging-related fibrosis and loss of SMC in the corpora cavernosa without affecting TGFB1 or PTPN11 levels, which are markers of oxidative stress. It may be speculated that similar effects may be achieved with this paradigm in men.

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Lower urinary tract symptoms and erectile dysfunction: Epidemiology and treatment in the aging man

Cited by 16 publications

References 57 publications

Body Mass Index and its Association with Genitourinary Disorders in Men Undergoing Prostate Cancer Screening

Body Mass Index and its Association with Genitourinary Disorders in Men Undergoing Prostate Cancer Screening

Emerging gene and stem cell therapies for the treatment of erectile dysfunction

Long-Term Continuous Treatment with Sildenafil Ameliorates Aging-Related Erectile Dysfunction and the Underlying Corporal Fibrosis in the Rat1

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