Patients with chronic renal failure (CRF) experience a significant decrease in their living quality, due to the limitations imposed by the disease as well as the demands of the treatment that they receive. Some side effects contribute to the morbidity of these patients. Among them, erectile dysfunction (ED) is notable. This article reviews recent advances in etiological factor study and treatment of ED in CRF patients, which may guide the clinic practices in a considerable scale.
Erectile Dysfunction ; etiology ; therapy ; Humans ; Kidney Failure, Chronic ; complications ; Male

Mild-symptom erectile dysfunction (MSED) is commonly seen in clinical practice, but receives inadequate attention from both the patients and clinicians. Increasing researches have indicated that MSED is associated with not only unhealthy living habits and psychological factors but also the early progression of endothelial, metabolic and endocrine diseases. The diagnosis and treatment of MSED should be based on the relevant guidelines, with consideration of both its specific and common features. The therapeutic principle is a combination of integrated and individual solutions aimed at the causes of the disease. Drug intervention should be initiated if psychological therapy fails. Negligence of MSED may affect the quality of life of the patients and their partners, and what's more, might delay the management of some other severe underlying diseases. Adequate attention to the early diagnosis and treatment for MSED is of great significance for a deeper insight into the etiology of ED, the prevention of potential cardiovascular and metabolic diseases, and the improvement of the overall health of males.
Attention ; Erectile Dysfunction ; diagnosis ; etiology ; therapy ; Humans ; Male ; Quality of Life

Hyperlipidemia is one of the risk factors leading to erectile dysfunction (ED), a common disorder in men, especially in old men. Epidemiological studies have found that the decrease in high density lipoprotein (HDL) and elevation of total cholesterol/high density lipoprotein (TC/HDL) are correlated with ED. Studies have also shown that arterial stenosis and occlusion caused by hyperlipidemia could be attributed to the advanced-stage mechanism of ED induced by hyperlipidemia. Hyperlipidemia may damage man's erectile function at an early stage by affecting the endothelial cells and smooth muscles of the penis and the peripheral nerves for penile erection. Apart from dietary therapy and drug therapy aiming at hyperlipidemia, the traditional Chinese medicine therapy and gene therapy are two promising approaches to the treatment of ED caused by hyperlipidemia.
Aged ; Erectile Dysfunction ; epidemiology ; etiology ; therapy ; Humans ; Hyperlipidemias ; complications ; epidemiology ; therapy ; Male

OBJECTIVETo investigate the etiology and individualized treatment of erectile dysfunction (ED) in young adult men.

METHODSIncluded in the investigation were 110 young adult men with ED, at the mean age of 28 (ranging from 22 to 39) and with the average disease course of 24 months (ranging from 6 to 48). The etiology of ED was determined for each patient by history inquiry, medical examination, laboratory investigation and erectile function test, and then individualized therapies were administered accordingly.

RESULTSOf all the diagnosed cases of ED, 42 (38.2%) were psychogenic, 36 (32.7%) organic and 32 (29.1%) of the mixed type. Four cases of schizophrenia were transferred elsewhere, 4 pelvic fracture induced cases gave up treatment, and the other 102 received individualized therapies, with the average effectiveness rate of 88.2%.

CONCLUSIONDetermination of the etiology of ED and the corresponding individualized treatment is the linchpin for improving the therapeutic effect of ED in young adult men.

Adult ; Clinical Laboratory Techniques ; Erectile Dysfunction ; diagnosis ; etiology ; therapy ; Humans ; Male ; Physical Examination ; Surveys and Questionnaires

OBJECTIVETo explore the distribution, combination and evolution of various syndromic etiologies of erectile dysfunction (ED) based on the syndrome etiology theory.

METHODSUsing the ED Syndromic Etiology Scale, we collected the clinical data on the Chinese medicine diagnoses of 297 cases of ED, extracted the core syndromic etiologies by analysis of principal components and factors, and analyzed the patterns of distribution, combination, and evolution of ED syndromic etiologies according to the general information of the patients.

RESULTSThrough analysis of principal components and factors, 9 core syndromic etiologies were extracted, i. e. , liver constraint with qi stagnation, kidney yin deficiency, damp-heat, liver constraint transforming into liver-fire, blood stasis, kidney yang deficiency, heart-spleen paired deficiency, qi-yin paired deficiency, and phlegm-damp. Each of these syndrome etiologies exhibited its own specific distribution patterns. Of the total number of cases studied, 51.52% had 2 or 3 core syndromic etiologies and 36.03% had only one.

CONCLUSIONIn the early stage of ED, its syndromic etiologies are usually liver constraint with qi stagnation, kidney yin deficiency, damp-heat, liver constraint transforming into liver-fire, and blood stasis. With the natural progres- sion of the disease, its syndromic etiologies gradually evolve into kidney yang deficiency, heart-spleen paired deficiency, qi-yin paired deficiency, phlegm-damp, and blood stasis, and finally into yin-yang deficiency of the heart, spleen and kidneys, combined with phlegm-damp and blood stasis.

Adult ; Erectile Dysfunction ; diagnosis ; drug therapy ; etiology ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged

OBJECTIVETo improve the clinician's ability for emergency treatment of priapism.

METHODSBoth cases received 2 mg to 8 mg of metaraminol injection at the root of cavernous body, and perfusion of heparinized saline at glans and root of cavernous body of the penis by contrecoup, but they had not good response to the above therapy. At last surgery was performed.

RESULTSTotal penectomy was performed for both cases. One case was diagnosed of penile sarcoma, and another was metastatic transitional cell carcinoma.

CONCLUSIONPriapism due to neoplasma is infrequent, it should not be misdiagnosed in case of emergency.

Erectile Dysfunction ; diagnosis ; etiology ; therapy ; Humans ; Male ; Middle Aged ; Penile Neoplasms ; complications ; surgery

In humans androgen decline is presented as a clinical picture which includes decreased sexual interest, diminished erectile capacity, delayed or absent orgasms and reduced sexual pleasure. Additionally, changes in mood, diminished well being, fatigue, depression and irritability are also associated with androgen insufficiency. The critical role of androgens on the development, growth, and maintenance of the penis has been widely accepted. Although, the exact effect of androgens on erectile physiology still remains undetermined, recent experimental studies have broaden our understanding about the relationship between androgens and erectile function. Preclinical studies showed that androgen deprivation leads to penile tissue atrophy and alterations in the nerve structures of the penis. Furthermore, androgen deprivation caused to accumulation of fat containing cells and decreased protein expression of endothelial and neuronal nitric oxide synthases (eNOS and nNOS), and phosphodiesterase type-5 (PDE-5), which play crucial role in normal erectile physiology. On the light of the recent literature, we aimed to present the direct effect of androgens on the structures, development and maintenance of penile tissue and erectile physiology as well. Furthermore, according to the clinical studies we conclude the aetiology, pathophysiology, prevalence, diagnosis and treatment options of hypogonadism in aging men.
Aging ; Androgens ; physiology ; Erectile Dysfunction ; Humans ; Hypogonadism ; diagnosis ; etiology ; therapy ; Male ; Testosterone ; therapeutic use

Erectile dysfunction (ED) seriously influences the quality of life of the patients and their partners. There are various methods for the treatment of ED, with medication as the first choice. This paper reviews the advances in the concept of treatment of ED, including regular treatment, maximal therapeutic effects, primary diseases inducing ED, and humanistic environment and ideal goal of ED treatment, aiming to help further understand the therapeutic concept and improve clinical management of the disease.
Erectile Dysfunction ; etiology ; psychology ; therapy ; Humans ; Male ; Quality of Life ; Sexual Partners

OBJECTIVETo investigate the influence of nasal continual positive airway pressure (nCPAP) on the erectile function of erectile dysfunction (ED) patients with obstructive sleep apnea syndrome(OSAS).

METHODSTwenty-seven patients with ED and OSAS were randomly divided into treatment (n = 15) and control (n = 12) groups, the former treated by nCPAP from 22:00 to 6:00 per night for 1 month. And the apnea-hypopnea index(AHI), the lowest oxygen saturation (SaO2) and IIEF were compared before and after treatment.

RESULTSAHI, the lowest SaO2, erectile function and IIEF showed no significant difference before treatment in the two groups, but displayed a significant improvement after treatment in the treated group compared with the control (P > 0.05), in which no significant changes were observed before and after treatment (P > 0.05).

CONCLUSIONnCPAP therapy can improve the erectile function of ED patients with OSAS.

Adult ; Aged ; Erectile Dysfunction ; etiology ; therapy ; Humans ; Male ; Middle Aged ; Nose ; Positive-Pressure Respiration ; methods ; Sleep Apnea, Obstructive ; complications ; therapy

Priapism is rare on clinical condition with complicated pathogenesis which is very difficult to cure. The paper reported a case of a long-time priapism, complicated local skin necrosis, which was caused by circumcision. After the failure of routine therapy, we treated the patient with traditional Chinese therapy, such as TCM herbs combined with bone scraping and depletion therapy, and achieved the satisfactory effect.
Adult ; Circumcision, Male ; adverse effects ; Combined Modality Therapy ; Erectile Dysfunction ; etiology ; therapy ; Humans ; Male ; Medicine, Chinese Traditional ; Necrosis