Primary Erectile Dysfunction

Stief, Christian G.; Bähren, W; Scherb, W; Gall, H.

doi:10.1016/s0022-5347(17)40750-6

Cited by 31 publications

(14 citation statements)

References 16 publications

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“…On the other hand, our previous study [19] and those of others [16][17][18] in castrated rats were limited to the prevention of erectile loss from the onset of androgen deprivation and not done as a delayed correction of a pre-existing condition as in the intact aged rats. The latter model has some similarities with human erectile dysfunction associated with a decrease of serum T, both in hypogonadal men as evidenced by lower nocturnal penile tumescence and sleeprelated erections [38,39], and in old men, as indicated by several criteria [10,[11][12][13]. Aging in humans is accompanied by borderline hypogonadism, particularly in terms of free T in serum [12-15, 38, 39].…”

Section: Discussionmentioning

confidence: 99%

“…Since it has been previously reported that aging in rats is associated with a decline of serum testosterone (T) [7][8][9], the question arose whether this moderate hypogonadism was responsible for the erectile dysfunction and the reduction in NOS activity observed in the senescent animals [1]. This is an important clinical issue because aging in humans is a well-recognized risk factor for impotence [10,11] and is accompanied by a decrease in serum T [12-151. The androgen dependence of erectile function has recently been studied separately from the effects on the libido Accepted August 7, 1995. Received May 12,1995. 'This work was supported by grants from the Tobacco Related Disease Research Program (TRDRP) of the University of California and from NIREC. in the EFS adult rat model by Mills et al [16,17], who showed that the erectile response is reduced approximately 50% solely by castration and that this decrease is prevented by exogenous T replacement.…”

Section: Introductionmentioning

confidence: 99%

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Restoration of Normal Adult Penile Erectile Response in Aged Rats by Long-Term Treatment with Androgens1

Garbán

Márquez

Cai

et al. 1995

Biology of Reproduction

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In order to determine whether the aging-related impairment of penile erection can be corrected by exogenous androgens, 20-mo-old ("old") rats received implants of Silastic tubing containing either testosterone (T) or dihydrotestosterone (DHT). Untreated aged-matched rats were used as reference controls, and values were compared with those obtained previously for 5-mo old ("adult") rats. After 45 days, groups of six rats were submitted to electrical field stimulation of the cavernosal nerve (EFS), and the intracavernosal pressure and mean arterial pressure (MAP) were recorded. Compared to the untreated old rats, the old animals receiving either T or DHT showed a similar and significant (p < 0.01) increase (56%) in the maximal intracavernosal pressure (MIP) to a level slightly above that of the untreated adult rats. The response was sensitive to the nitric oxide synthase (NOS) inhibitor Nw-nitro-L-arginine methyl ester (L-NAME). The MIP:MAP ratio in the treated animals was nearly double that found in the old untreated controls. Penile NOS activity was measured by the [3H]L-arginine-citrulline conversion, and neuronal NOS (nNOS) levels were estimated by a semiquantitative Western blot assay with antibodies against human nNOS. No significant variations were observed in either NOS levels or NOS activity between the treated and untreated old rats. These results suggest that aging-related erectile dysfunction in the intact rat may be responsive to androgen therapy and that this correction is not associated with an increase in the basal levels of penile NOS, in contrast to what occurs in castrated rats.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Restoration of Normal Adult Penile Erectile Response in Aged Rats by Long-Term Treatment with Androgens1

Garbán

Márquez

Cai

et al. 1995

Biology of Reproduction

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“…Stief et al [33] found CVL in 52% of patients with pri mary erectile dysfunction. Similarly, CVL was present in 50-62% of primary impotent patients in the present study.…”

Section: Discussionmentioning

confidence: 98%

Pharmacocavernometry with Prostaglandin E(1)

Ho¹,

Ml²

1993

Eur Urol

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“…In a series of 67 eugonadal patients, primary ED was attributed to psychogenic factors in 16% and organic causes in 85% patients, namely neurological (18%), arteriogenic (52%), and venogenic (52%). Concomitant psychogenic abnormalities were found in 68% of patients with organic primary ED [1].…”

Section: Introductionmentioning

confidence: 99%

Primary erectile dysfunction

Shaeer¹,

Shaeer²

2011

Human Andrology

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PurposePatients with primary erectile dysfunction (ED) are unable to report on the possibly existing congenital penile curvature. Curvature is recognized only after implantation, in which case the implant can be extracted and its length modified or the curvature corrected, adding to the complexity of the procedure and the risk of infection. This study describes a method to evaluate congenital curvature in cases of primary ED before surgery and to correct curvature upon prosthesis implantation, even before calibration of the corpora cavernosa. Materials and methodsBefore prosthesis implantation, artificial erection is induced by basal compression and saline infusion, demonstrating curvature, if any. Surgery is performed through a penoscrotal incision. One or more cruciate corporotomy incisions are cut over the point of maximum curvature, straightening the penis. Full correction is checked by covering the corporotomy with sterile surgical glove material sutured to its edges and by reinducing artificial erection. Dilatation of the corpora, calibration, and implantation proceeds as usual and the corporotomies are sealed by a tunica vaginalis graft. ResultsCurvature was demonstrated in nine out of 16 cases, necessitating correction in four, in whom curvature was fully corrected and prosthesis was successfully implanted and followed for 6-8 months. ConclusionCongenital curvature can coexist with primary ED (nine out of 16 patients in this series); yet, it is not reported by the patient who has never experienced a rigid erection sufficient to reveal the curvature. Preoperative detection of curvature is of value for patient counseling and planning of the procedure. Correction of curvature before implantation (in the same session) can help implanting the suitable length of prosthesis in a straight penis, without undue complexity and risk of infection.

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Primary Erectile Dysfunction

Cited by 31 publications

References 16 publications

Restoration of Normal Adult Penile Erectile Response in Aged Rats by Long-Term Treatment with Androgens1

Restoration of Normal Adult Penile Erectile Response in Aged Rats by Long-Term Treatment with Androgens1

Pharmacocavernometry with Prostaglandin E(1)

Primary erectile dysfunction

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