Vasculogenic erectile dysfunction in teenagers: a 5‐year multi‐institutional experience

Tal, Raanan; Voelzke, Bryan B.; Land, Spencer; Motarjem, Pejman; Munárriz, Ricardo; Goldstein, Irwin; Mulhall, John P.

doi:10.1111/j.1464-410x.2008.08037.x

Cited by 18 publications

(15 citation statements)

References 29 publications

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“…Sexual dysfunction among young men in their second decade of life is commonly under investigated and under treated. There is a paucity of literature on sexual dysfunction in young men, and only a single publication on sexual dysfunction in teenagers [6]. This single publication focused on penile hemodynamic testing in teenagers with erectile dysfunction (ED), but did not look at PD or other sexual dysfunctions in teenagers.…”

Section: Introductionmentioning

confidence: 99%

Peyronie’s Disease in Teenagers

Tal

Hall

Alex

et al. 2012

The Journal of Sexual Medicine

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Introduction Peyronie’s disease (PD) is commonly seen in middle-aged men, and little is known about this condition in teenagers. Aim To investigate the characteristics of PD in teenagers. Methods The findings were compared between patients with the disease who were teenagers with those over 40 years of age. Statistical analyses were conducted to define differentiating features between these two groups. Main Outcome Measures The demographics, clinical features, and associated comorbidities of patients with PD were reviewed. Results Thirty-two teenaged males were evaluated for PD in a single institution over a 10-year period. The median age for our cohort was 18 (15–19) years. Forty-five percent of patients had already been seen by another urologist, and 28% had been told they did not have PD. The mean duration of PD before seeking medical care in our cohort was 3 ± 1 months. Sixteen percent of patients reported antecedent penile trauma, half of which happened during coitus or masturbation, and 18% of patients had hemoglobin (Hb) A1c levels > 5%. Dupuytren’s contracture was not seen in this population. Twenty-two percent of patients presented with penile pain. Subsequent ED was seen in 37% of patients. Multiple noncontiguous plaques were seen in 37% of patients. Twelve percent were previously treated with vitamin E, while another 12% had previous intralesional verapamil. High distress was reported by 94% of patients. Thirty-four percent sought medical attention for anxiety/mood disorder, and 28% had a negative encounter with a sexual partner related to PD. All of the 32 patients had penile curvature with a mean of 32 ± 12 degrees. Seventy-two percent of the patients had dorsal curvature while 22% had an associated deformity. Using duplex Doppler ultrasound, 12% had a calcified plaque, while none of the patients had abnormal hemodynamics. When compared with PD in adults, teenagers had greater than seven times the prevalence of multiple noncontiguous plaques (37% vs. 5%). Also, the prevalence of HbA1c level > 5% was higher in the teenagers as well (18% vs. 5%). Conclusions PD does occur in teenagers often causing high distress levels. Compared to older adults, teenagers often present earlier, and more commonly have elevated HbA1c level and increased number of plaques at presentation.

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Section: Introductionmentioning

confidence: 99%

Peyronie’s Disease in Teenagers

Tal

Hall

Alex

et al. 2012

The Journal of Sexual Medicine

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“…Although ED has been extensively studied in older men, there are few published data regarding ED in young individuals (Tal et al, 2009). In a large sample accessed by telephone in France, ED was reported by 9% and 12% of men aged 18 to 19 and 20 to 24 years, respectively (Béjin, 1999).…”

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confidence: 99%

“…In a large sample accessed by telephone in France, ED was reported by 9% and 12% of men aged 18 to 19 and 20 to 24 years, respectively (Béjin, 1999). The underlying etiology and risk factors associated with juvenile ED have not been previously studied, but the origin of ED has been reported to be primarily psychogenic in at least 52% of teenaged patients (Tal et al, 2009).…”

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Effects of Chronic Stress on Penile Corpus Cavernosum of Rats

Souza¹,

Silva

Cortez

et al. 2012

Journal of Andrology

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The objective of this study was to investigate structural changes in the penile corpus cavernosum of prepubertal chronically stressed rats. Eight Wistar rats were assigned into the stress group (SG) and were submitted to 2 hours of tube restraint daily, from the fourth to the ninth week of life. Another 7 rats were used as the control group (CG). All animals were weighed weekly. At day 64, animals were sacrificed by anesthetic overdose, blood was collected for testosterone concentration by radioimmunoassay, and penis and adrenal were collected. Adrenal mass index and testosterone serum levels were used to assess the efficacy of the stress stimulus. The surface density of connective tissue and smooth muscle fibers of corpus cavernosum were measured on Masson trichromic-stained slices. Picrosirius red-stained slices were assessed under polarized light for different types of collagen. The Student's t test was applied for mean comparisons, with P , .05 considered significant. Testosterone serum concentrations decreased and adrenal mass index increased, confirming the effectiveness of the stress protocol. Smooth muscle fibers of corpus cavernosum decreased from 14.07% (CG) to 8.98% (SG) (P 5 .02), and connective tissue increased from 53.66% (CG) to 64.47% (SG) (P 5 .01). Also, there was a higher level of type I collagen in the SG animals compared with the CG. Stress stimuli induced structural changes in the corpus cavernosum of rats suggestive of penile fibrosis, which may play a role in erection dysfunction.

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“…Basic science research on erectile physiology has been devoted to investigating the pathogenesis of ED and has led to the conclusion that ED is predominately a disease of vascular origin. Patients who had a vascular evaluation and vascular pathology can classify as arteriogenic ED, venogenic ED, and mixed vasculogenic ED (Tal et al, 2009). The incidence of ED dramatically increases in men with diabetes mellitus, hypercholesterolemia, and cardiovascular disease.…”

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The Association of Serum Prolidase Activity and Erectile Dysfunction

Savaş

Yeni

Çelik

et al. 2010

Journal of Andrology

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Prolidase is a cytosolic exopeptidase that cleaves iminodipeptides with carboxy-terminal proline or hydroxyproline and plays a major role in collagen turnover. Collagen is the essential content in atherosclerotic plaque, playing a key role in the stability/ instability and progression of endothelial dysfunction in the pathogenesis of erectile dysfunction (ED). Consequently, in this study we sought to determine serum prolidase activity and markers of oxidative stress, such as lipid hydroperoxide and total free sulfhydryl, in vasculogenic ED. We evaluated 92 patients with vasculogenic ED and 50 control subjects by clinical and laboratory investigations. We measured serum prolidase activity and serum total free sulfhydryl levels spectrophotometrically. Serum lipid hydroperoxide levels were determined with ferrous ion oxidationxylenol orange method. We assessed the association of serum prolidase activity with the presence and severity of vasculogenic ED and clinical characteristics, as well as laboratory parameters. We also assessed the association of serum prolidase activity with the variables according to the vascular status of patients with vasculogenic ED. The comparison included 92 vasculogenic ED patients grouped into 3 categories according to the vascular status of patients with ED-arterial insufficiency (n 5 26), veno-occlusive dysfunction (n 5 37), and mixed-type impotence (n 5 29)-and 50 controls. Receiver-operator characteristics (ROCs) were analyzed to find a cutoff value with the best sensitivity and lowest falsepositive rate. Serum prolidase activity (53.5 6 5.5 U/L vs 45.7 6 4.9 U/L, respectively; P , .001) and serum lipid hydroperoxide levels were significantly increased in patients with vasculogenic ED compared with controls, whereas serum total free sulfhydryl levels were significantly decreased in patients with vasculogenic ED compared with controls (P , .001). The lowest and highest mean serum prolidase activities were detected in control participants and in patients with arterial insufficiency, respectively (analysis of variance P , .001). The overall findings of this study support the predictive accuracy of the serum prolidase activity in our cohort, with a statistically significant ROC value of 0.78. Findings of this study have shown that serum prolidase activity is significantly associated with the presence and severity of vasculogenic ED, and elevated serum prolidase activity might be an independent predictor of ED.

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Vasculogenic erectile dysfunction in teenagers: a 5‐year multi‐institutional experience

Cited by 18 publications

References 29 publications

Peyronie’s Disease in Teenagers

Peyronie’s Disease in Teenagers

Effects of Chronic Stress on Penile Corpus Cavernosum of Rats

The Association of Serum Prolidase Activity and Erectile Dysfunction

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