Testosterone Undecanoate Restores Erectile Function in a Subset of Patients with Venous Leakage: A Series of Case Reports

Yassin, Aksam; Saad, Farid; Traish, Abdulmaged M.

doi:10.1111/j.1743-6109.2006.00267.x

Cited by 84 publications

(63 citation statements)

References 40 publications

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“…Testosterone may repair venous leakage in hypogonadal patients and subjects with metabolic syndrome. The impact of a hormonal factor on venoocclusive properties of the corpora cavernosa indicates that restoration of testosterone to normal may repair mechanical damage of the corpora cavernosa (Yassin & Saad, 2006;Yassin et al, 2006b;Kurbatov et al, 2008). This has also been found to be the case in laboratory animals.…”

Section: Androgens and Sexual Functioningmentioning

confidence: 86%

Cardiovascular diseases and erectile dysfunction: the two faces of the coin of androgen deficiency

et al. 2010

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Traditionally, clinical conditions synonymous with the ageing male included cardiovascular disease (CVD), type 2 diabetes mellitus (DM) and sexual dysfunction, and were widely regarded as independent clinical entities. Over the last decade, interrelationship of clinical conditions has been convincingly demonstrated. Declining testosterone levels in the elderly, once regarded as an academic endocrinological question, appear to be central to the listed pathologies. It is now clear that erectile dysfunction is an expression of endothelial dysfunction. Testosterone deficiency is associated with an increased incidence of CVD and DM. The latter is often the sequel of the metabolic syndrome. Visceral obesity, a pivotal characteristic of the metabolic syndrome, suppresses the hypothalamic-pituitary-testicular axis leading to diminished testosterone production. Conversely, substantial androgen deficiency leads to signs and symptoms of metabolic syndrome. It is erroneous not to include testosterone measurements in the progress of the CVD, DM and erectile dysfunction. These conditions correlate strongly with testosterone deficiency.

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Section: Androgens and Sexual Functioningmentioning

confidence: 86%

Cardiovascular diseases and erectile dysfunction: the two faces of the coin of androgen deficiency

et al. 2010

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“…In addition, vasculitides, independent of their classification criteria, may involve several organs, thus generating overlapping syndromes and heterogeneous clinical features that may also include unusual targets such as testis. Testicular necrosis, which caused hypogonadism, likely contributed to venogenic ED [15]; nevertheless, it could be an intriguing hypothesis that ED may also partially depend on the involvement of venules of the corpora cavernosa. It was not possible to confirm such a hypothesis either by a cavernosography, which is considered the reference diagnostic standard for venogenic ED, or by a cavernosal biopsy.…”

Section: Discussionmentioning

confidence: 98%

Microscopic polyangiitis with sexual and reproductive system involvement: first description of a case

et al. 2008

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Microscopic polyangiitis (MPA) is a rare systemic vasculitis with an incidence of about 1-3/100,000/year [1]. MPA is defined as a necrotizing vasculitis, with few or no immune deposits, primarily affecting small vessels including capillaries, venules or arterioles [2]. MPA mainly affects kidneys and lungs, nevertheless cutaneous vasculitis, musculoskeletal symptoms, gastrointestinal involvement and peripheral neuropathy also occur [3]. Circulating antineutrophil cytoplasm antibodies (ANCA) are present in about 74.5% of patients with MPA, mainly perinuclear ANCA with specificity for myeloperoxidase (p-ANCA) [4], more rarely, in about 40% of the cases, cytoplasmic ANCA with specificity to proteinase-3 (c-ANCA) are present [5]. Depending on the extent of systemic vascular involvement, clinical findings can be quite variable; nevertheless, sexual and reproductive system involvement in patients with MPA has not previously been reported. Case reportWe report the case of a male with MPA involving the lungs, kidneys, peripheral nervous system, muscoloskeletal apparatus and the reproductive system. The patient, a 53-yearold man, was hospitalized in another institution because of malaise, slight temperature, myalgia and arthralgia, which had begun 2 months earlier; these symptoms were relieved by a steroid therapy. Systolic and diastolic blood pressure values were 130/80 mmHg, and heart rate was 75/min. Laboratory tests showed leucocytosis (WBC:11.000 U/lL) with neutrophilia (79%), microhematuria (5-10 RBC for microscopical field) and high values of erythrocite sedimentation rate (ESR 51 mm/h) and C-reactive protein (CRP 49 mg/L), whereas the remaining tests, including glycemia (86 mg/dL), total cholesterol (156 mg/dL), triglycerides (80 mg/dL) and high-density lipoprotein (52 mg/dL), were within the normal range. Moreover, c-ANCA were highly positive. The ear, throat and nose examination showed no abnormalities. A computed tomography scan of the thorax showed several opacities in the inferior pulmonary lobe, bilaterally, with no evidence of nodular or cavitary images. Seriate blood cultures, Mantoux intradermal reaction (5U reading 48 and 72 h), Widal-Wright and Weil Felix serodiagnosis as well as tumor markers were negative, thus ruling out infectious diseases and malignancies. An electroneurography revealed a bilateral peripheral neuropathy of the deep peroneal nerve as well. During hospitalization a testicular ultrasound was performed because of the onset of a dull right testicular pain. The exam depicted an enlarged right testis with a predominantly hyperechogenic area (33 mm, irregular borders), with hypoechogenic internal areas. This lesion was mainly peripherally vascularized, with poor signals internally. A smaller area with similar

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“…Compared with baseline pharmacocavernosography, repeat radiologic studies in patients who reported improvement in erectile function no longer showed venous leakage, with veins draining the corporal bodies. The patients who responded to androgens also noted improvement in sexual desire domain (IIEF scores increased from 4 ± 0.7 to 8 ± 0.3) and erectile function domain (IIEF scores increased from 6 ± 2 to 24 ± 1) [29]. These observations were in a limited series of cases, but they suggest that testosterone improves erectile function in hypogonadal patients by restoring venoocclusive function in patients who had earlier not responded to PDE5 inhibitors and alprostadil injections [29].…”

Section: Studies On Treatment Of Hypogonadal Men With Sexual Dysfunctmentioning

confidence: 88%

The role for intramuscular testosterone injection in the gel era

Yassin¹

2007

Curr sex health rep

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New treatment modalities for testosterone deficiency have evolved, such as the gels and the long-acting parenteral testosterone undecanoate (TU). Both fulfill the criteria of adequate androgen therapy, have proven to be effective in ameliorating sexual functions in young and elderly men, and are safe. Their mode of administration could not be more divergent; the gel requires daily application, but TU is administered every 12 weeks intramuscularly. A patient receiving long-acting TU being at higher risk when diagnosed with prostate carcinoma than one being treated with a gel is no longer believed, because the delay between diagnosing and treating prostate carcinomas almost always exceeds the duration of action of TU, which is 12 to 14 weeks. So, TU appears to be a viable alternative to the gels and will be preferred by many patients as a lesser interference with their daily lives.

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Testosterone Undecanoate Restores Erectile Function in a Subset of Patients with Venous Leakage: A Series of Case Reports

Cited by 84 publications

References 40 publications

Cardiovascular diseases and erectile dysfunction: the two faces of the coin of androgen deficiency

Cardiovascular diseases and erectile dysfunction: the two faces of the coin of androgen deficiency

Microscopic polyangiitis with sexual and reproductive system involvement: first description of a case

The role for intramuscular testosterone injection in the gel era

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