PURPOSE: This study evaluated the diagnostic utility of a 3-Dimensional head mounted display(HMD) in audiovisual sexual stimulation(AVSS). MATERIALS AND METHODS: A total of 45 men were included in this study: 15 healthy, 15 patients diagnosed with organic impotence, and 15 patients with psychogenic impotence. The NEVA(Nocturnal Electrobioimpedance Volumetric Assessment) system was performed during AVSS with both the 3-D HMD and a conventional monitor. In this study, normal erection was defined as a change in penile blood volume of more than 200% over the baseline for more than 5 minutes. After AVSS, each subject rated his sexual drive as grade I(poor), II(moderate), or III (good). RESULTS: Use of the conventional monitor produced a normal state in 8 men: 5 healthy volunteers(33%) and 3 patients with psychogenic impotence(20%). Use of the 3-D HMD produced a normal state in 23 men: 12 healthy volunteers(80%) and 11 patients with psychogenic impotence(73%). In the healthy volunteers and psychogenic impotence group, the duration of erectile events and percent of volume increase from baseline increased significantly more with 3-D HMD than with the conventional monitor. Compared to results using the conventional monitor, the subjects' sexual drive with 3-D HMD was also significantly increased(p<0.05). CONCLUSIONS: AVSS with 3-D HMD improves the recording of physiological erectile response and may be a valuable tool in making the correct diagnosis of erectile dysfunction.
Blood Volume ; Diagnosis ; Erectile Dysfunction ; Head* ; Healthy Volunteers ; Humans ; Male

Although elevated prolactin levels have been shown to inhibit penile erection, the relationship between prolactin and erection of the penile tip or base has not been extensively researched. We therefore investigated the prolactin's effects on erection of the penile tip and base, with a cross-sectional study of 135 patients with erectile dysfunction, based on scores of ≤21 on the International Index of Erectile Function-5. All patients were tested for nocturnal penile tumescence, blood pressure, serum glucose, total cholesterol, triglyceride, high-density lipoprotein, low-density lipoprotein, luteinizing hormone, follicle-stimulating hormone, prolactin, estradiol, testosterone, and progesterone. Univariate and multivariate analyses were used to assess the associations between prolactin levels and erection at the penile tip and base. We found no obvious relationship between erection time at penile tip and prolactin levels, but observed a negative correlation between base erection time and prolactin level (hazard ratio: -2.68; 95% confidence interval [CI]: -5.13--0.22). With increasing prolactin concentration, multivariate analysis showed obvious reduction in base erection time among patients with normal Rigiscan results (hazard ratio: -3.10; 95% CI: -7.96-1.77; P < 0.05). Our data indicate that prolactin inhibits penile erection, particularly at the penile base. In addition, when the effective erection time of the penile base lasts longer than 10 min, prolactin has a more obvious inhibitory effect on penile base erection.
Adult ; Cross-Sectional Studies ; Erectile Dysfunction/blood* ; Humans ; Male ; Penile Erection ; Prolactin/blood* ; Time Factors

Although several reference values of the cavernosal arterial flow velocity were reported for defining the normal vascular condition including good arterial inflow and corporal venoocclusive function, still we have some confusions and limitations to interpret the results because of lack of standardization of some various factors relating to performing duplex scanning. Here in, we evaluated the effect of cavernosal arterial location that is measured by Doppler spectrum on the values of blood flow velocity. 36 patients with suspecting vasculogenic impotence entered the study. Color duplex sonography was performed in all patients. We obtained velocity measurements at 3 to 8 min intervals in both cavernosal arteries for at least 20 min after injection of PGE1 10ug. The cavernosal artery peak systolic flow velocity (PSV) and end diastolic flow velocity (EDV) were measured at two portions. the base over the ascending portion of cavernosal artery( 'Proximal') and midshaft( 'Distal') of the penis in each session. We classified the patients based on the results of Proximal values of duplex parameters into normal(maximal PSV>30 cm/sec and minimal EDV<5cm/sec throughout the study; NL group: n=8), arterial insufficiency with or without venous incompetency(maximal PSV< 25cm/sec; AI group: n=l2) and venous incompetency without arterial insufficiency(maximal PSV>30cm/sec and minimal EDV>5cm/sec; VI group n= 16). When we compared PSV values between two portions of measurement in each group all the Distal PSV values were significantly lower than Proximal(p<0.06) in NL and VI group, but no statistical difference was noted in PSV values of AI group(p>0.05). If we considered only Distal values for patient grouping 63% of VI group and 50% of NL group had maximal PSV values less than 25cm/sec that would be reclassified into arterial insufficiency. On the other hand, resistance index(RI) values remained unchanged regardless of measurement location in all groups. With the above results we can conclude that there is an obvious difference of blood flow velocities between two portions of measurement(Proximal vs Distal) and Proximal value is more reliable than Distal when we diagnose with previously reported normal reference value (PSV>30-35cm/sec).
Alprostadil ; Arteries ; Blood Flow Velocity ; Erectile Dysfunction ; Female ; Hand ; Humans ; Impotence, Vasculogenic ; Male ; Penis ; Reference Values

We designed this study to investigate the effects of adenosine on penile erection in Sprague- Dawley rats, in vivo. This was performed by simultaneous monitoring intracavernosal pressure( ICP) and systemic blood pressure with UROCOMPACT 6000 plus( WIEST, Germany) after intracavernosal injection of adenosine, papaverine and adenosine plus papaverine. Increment of maximal ICP was observed in the adenosine treated-group (0.015 to 0.15mg, n=30) in dose dependent manner, i.e., 15.8+/-0.95cmH2O with 0.015mg adenosine to 44.6+/-2.72cmH2O with 0.15mg adenosine, in mean ICP(n=l0, P<0.05). A similar finding was observed in the papaverine treated-group (0.015 to 0.15mg, n =30) in dose dependent manner. i.e., 28.1+/-2.88cmH2O with 0.015mg papaverine to 62.3+/-4.93cmH2O with 0.15mg papaverine, in mean ICP (n=10, P<0.05). The additive effect of adenosine plus papaverine treated-group( 0.015 + 0.015 to 0.15 +0.l5mg, n=30) was to enhance the results obtained by adenosine or papaverine alone in dose dependent manner. i.e., 50.7+/-1.71cmH2O with 0.015mg + 0.015mg papaverine to 79.5+/-5.63cmH2O with 0.15mg adenosine + 0.15mg papaverine. in mean ICP(n= 10, P<0.05). These results suggest that adenosine plays an important role on penile erection in rats. Adenosine may be useful for the future management of impotence, although the clinical effect remains to be investigated.
Adenosine* ; Animals ; Blood Pressure ; Erectile Dysfunction ; Male ; Papaverine ; Penile Erection* ; Rats*

PURPOSE: The aim of this study was to evaluate the efficacy and safety of a herbal formula that mainly consists of Cornus officinalis for treating erectile dysfunction. MATERIALS AND METHODS: Eighty patients suffering with erectile dysfunction were enrolled in this randomized, double-blinded, placebo-controlled study. The average duration of erectile dysfunction of the herbal formula group(n=40) vs. the placebo group(n=40) were 19.33+/-18.13 months vs. 19.33+/-25.62 months, respectively. The safety variables we examined were the history, physical examination, vital signs, EKG, clinical laboratory tests and hormonal tests. Efficacy assessments included the International Index of Erectile Function(IIEF), the sexual encounter profile(SEP) diary and Global Assessment Questions(GAQ). RESULTS: No significant changes in the laboratory values, hormone tests and blood pressure were observed in both groups. In comparison with the placebo group(6.57+/-11.72), the herbal formula group experienced a significant improvement of the IIEF(11.13+/-11.83)(p<0.05). When the herbal formula and placebo groups were divided by age and the IIEF score (age: 50 years and IIEF: 42) and then compared, the low IIEF group(IIEFor=50) of the herbal formula group significantly improved their IIEF score(p<0.05). The herbal formula group significantly improved their GAQ score(p<0.05). The herbal formula was well tolerated. The common adverse events were headache(2.5%) and nausea(5%). CONCLUSIONS: In conclusion, the herbal formula that mainly consists Cornus officinalis was not only effective at improving erectile function, but it was also safe for the treatment of erectile dysfunction.
Blood Pressure ; Cornus* ; Electrocardiography ; Erectile Dysfunction* ; Humans ; Male ; Physical Examination ; Treatment Outcome ; Vital Signs

Penile and digital systolic pressures were measured with Doppler ultrasonic sthetoscope in 65 normal subjects. This technique is simple, reliable, inexpensive OPD procedure for the detection of penile arterial lesion in patients with impotence. With this study, we concluded that normal men have a PDI ratio above 0.77, and impotent men have a. PDI ratio below 0.63. However, the ratio range from 0.63 to 0.77 is borderline range which is not clearly impotent or normal. Hyperemic stress test is indicated the patient with borderline range. Pelvic steal test can detect vascular pathological condition previously missed by PDI. We indicate this test in the patients with history of intermittent gluteal claudication. We concluded that arteriogenic impotence is easily diagnosed by PDI combined with hyperemic stress test and pelvic steal test, if indicated.
Blood Pressure* ; Erectile Dysfunction ; Exercise Test ; Female ; Humans ; Impotence, Vasculogenic ; Male* ; Reference Values* ; Ultrasonics

Male sexual function gradually decreases in parallel with aging. As the majority of diabetes mellitus develops later in life, mostly beyond the fifth decade, impotence in the diabetic patients can be ignored by physician as well as patients. Considerable evidence, however, indicates that diabetes mellitus does affect the male sexual function more significantly in diabetics than in non-diabetic is suspected. We studied 213 male diabetic patients and 233 non-diabetic male patients who were neither on medication nor have systemic diseases affecting sexual dysfunction. We analyzed the questionnaire regarding libido, erectile potency, intercourse frequency and partner's satisfaction, and we got several results as followings. In the diabetics, the prevalence of impotence was 20.4%, which was significantly higher than that(13.7%) of the control(p<0.01). Although the prevalence of impotence increases with aging in both groups, it was significantly higher in diabetic under the 7th decade and positively related to the disease duration. The erectile potency was also significantly lower in the diabetics. The scores of libido, intercourse frequency and partner's satisfaction were significantly lower in the diabetic compared with those in the control. The erectile potency was revealed to be higher in the patients whose blood glucose levels were controlled, compared with that of the patients with the uncontrolled levels. These results suggest that the prevalence of impotence is similar in Korean diabetic patients to those of the western countries, and the early treatment of diabetes mellitus is important for theprevention of impotence.
Aging ; Blood Glucose ; Diabetes Mellitus ; Erectile Dysfunction ; Humans ; Libido ; Male* ; Prevalence ; Surveys and Questionnaires

Forty two patients including 1O cases of the normal control were studied with the radioisotope penogram. The causes of the impotence were arteriogenic in 1O cases, venogenic in 6, diabetes mellitus in 8, neurogenic in 2, endocrinogenic in 1 and psychogenic in 15, ranging from 19 to 70 years of age. Ten normal volunteers for the control group were ranged from 21 to 38 years of age. All were subjected to Snap-Gauge test and measurement of the penile blood pressure with estimation of the penile brachial index (P.B.I.). We calculated the Penogram Index in time-activity curve of the radioisotope penogram and studied the inter-relationship between the Penogram Index and the etiologic diseases, Snap-Gauge test, PBI. The results were obtained as follows; 1. Inter-relationship between the diseases and the penogram index, arterial index (Index A) and venous index (Index V1, V2); 1) Index A was 1.44 in normal control group, 0.55 in arteriogenic. 0.62 in venogenic, 0.64 in diabetes mellitus, 0.95 in neurogenic, l.29 in endocrinogenic and 1.03 in psychogenic impotence. This suggested that Index A was significantly correlative with state of the penile arterial inflow. 2) Index V1, V2 were 0.09, 90 in normal control group, 0.09, 51 in arteriogenic, 0.40, 29 in venogenic, O.8l, 38 in diabetes mellitus, 0.84, 90 in neurogenic, O.92, 34 in endocrinogenic, and 0.91, 64 in psychogenic impotence. This suggested that Index V1 and V2, particularly V1 was representative of maintenance of the penile blood flow and the penile venous outflow or leak. 2. Relation between Snap-Gauge test and Index A; Correlated in 77.8% of the patients and the normal controls, respectively. 3. Relation between P.B.I. and Index A; Correlative. 4. Relation between P.B.I and Index V1, V2; Not correlative Therefore, the radioisotope penogram was a very useful method in diagnosis of the organic impotence, particularly vasculogenic impotence to different late arteriogenic and venogenic.
Blood Pressure ; Diabetes Mellitus ; Diagnosis* ; Erectile Dysfunction* ; Female ; Healthy Volunteers ; Humans ; Impotence, Vasculogenic ; Male

Purpose: This study aimed at evaluating the expected additive blood pressure (BP) lowering effect of vardenafil when administered in the background of chronic alpha1-blocker therapy. Materials and Methods: Patients (n=90) with symptomatic benign prostatic hypertrophy (BPH) and erectile dysfunction (ED) took vardenafil 20mg in the morning following repeated doxazosin gastrointestinal therapeutic system (GITS) 4mg (n=60) or tamsulosin 0.2mg (n=30) HS a day for 30 days. The standing and sitting BP at baseline, before taking the vardenafil and 30 minutes and 1 hour post vardenafil were measured 3 consecutive times. The data were analyzed by Student's t-test (paired), repeated measures of two-way ANOVA, chi-square tests and Pearson correlation analysis. Results: Doxazosin produced a significant reduction in systolic/diastolic BP ( 12.3/ 6.7mmHg), but tamsulosin did not. In the doxazosin group, the average reductions in BP from baseline ( 24.7/ 15.8mmHg) were significantly higher than that for the tamsulosin group ( 14.6/ 7.5mmHg). However, the average BP change was not different in both group ( 12.4/ 9.1mmHg in the doxazosin group and 11.3/ 6.4mmHg in the tamsulosin group) following a single dose of 20mg vardenafil. The higher the BP was at baseline, the more the reduction in BP was in both the doxazosin and tamsulosin groups. Two patients of tamsulosin showed a sitting systolic BP <85mmHg, but they didn't experience dizziness. Conclusions: We recommend starting Vardenafil treatment in the background of chronic aalpha1 blocker therapy, including tamsulosin, with a low dose and to increase the dose by monitoring the BP, particularly for the patients with hypertension.
Blood Pressure* ; Dizziness ; Doxazosin* ; Drug Interactions* ; Erectile Dysfunction* ; Humans ; Hypertension ; Male ; Prostatic Hyperplasia* ; Vardenafil Dihydrochloride

A clinical trial was done to evaluate the antihypertensive efficacy and side effects of manidipine, a new calcium antagonist, in 30 patients with mild to moderate essential hypertension. 1) The study patients consisted of 19 men and 11 women, and the mean age was 51.8 years. 2) Blood pressure dropped significantly in 2 weeks and in 4 weeks, and well maintained throughout the study period. The mean-pressure drop was 26.2/14.9mmHg after 10 weeks. 3) Heart rate did not change significantly with manidipine therpy. 4) Optimal dose for effective pressure-drop was between 10 and 20 mg in 86% of patients. Overall good antihypertensive effect was achieved in 83% of patients. 5) All of the laboratory parameters including blood chemistry, glucose, lipid and electrolytes did not change, but serum calcium increased from 9.2% mg/dl (p=0.001) in 10 weeks. 6) Side effects were mild in nature(palpitation in 3, dry mouth in 1, weakness in 1 and impotence in 1 patient). In conclusion, manidipine monotherapy with 10 to 20 mg once a day regimen is effective and well tolerated in the patients with mild to moderate essential hypertension.
Blood Pressure ; Calcium ; Chemistry ; Electrolytes ; Erectile Dysfunction ; Female ; Glucose ; Heart Rate ; Humans ; Hypertension* ; Male ; Mouth