Relaxation and contraction factors influencing penile erection are produced and released by the central and peripheral nerves as well as intracavernosal sinus gap and vascular endothelial cells. Aging, diabetes, cardiovascular disease and spinal cord injury can influence these factors. Further researches of hyperbaric oxygenation (HBO) on the erectile dysfunction (ED) can provide some theoretical evidences for the clinical treatment of ED.
Erectile Dysfunction ; therapy ; Humans ; Hyperbaric Oxygenation ; Male ; Penis ; physiopathology

Penile erection hardness is one of the key factors for successful sexual intercourse, as well as an important index in the diagnosis and treatment of erectile dysfunction (ED). This article gives an overview on the component and impact factors of erection hardness, summarizes some commonly used evaluation methods, including those for objective indexes, such as Rigiscan, axial buckling test and color Doppler ultrasonography, and those for subjective indexes of ED patients, such as IIEF, the Erectile Function Domain of IIEF (IIEF-EF), and Erection Hardness Score (EHS), and discusses the characteristics of these methods.
Erectile Dysfunction ; diagnosis ; physiopathology ; Humans ; Male ; Penile Erection

Endothelial function plays a very important role in the process of erection. Erectile dysfunction (ED) and coronary artery disease (CAD) overlap in risk factors, aetiology and clinical outcomes. Endothelial dysfunction is considered to be their shared aetiological factor. There is growing evidence that patients presenting with ED should be investigated for CAD, even if with no symptoms of the problem. Earlier diagnosis of ED can facilitate prompt intervention, reduce long-term complications, especially the risk of CAD, and provide effective treatment for ED.
Arteriosclerosis ; physiopathology ; Coronary Artery Disease ; physiopathology ; Endothelium, Vascular ; physiology ; physiopathology ; Erectile Dysfunction ; physiopathology ; Humans ; Male ; Penis ; blood supply ; physiopathology

Recently, we have a further understanding on the pathogeny of erectile dysfunction, and with the application of so many new technologies, such as color Doppler ultrasound, electrical impedance, evoked potential, sensor etc. The diagnosis of ED becomes more and more scientific and convenient. Today we make a review on all kinds of diagnosing methods in order to recognise it more clearly and to provide some more precise and practical way for forensic evaluation in future.
Erectile Dysfunction/physiopathology* ; Evoked Potentials, Somatosensory ; Forensic Medicine ; Humans ; Male ; Penis/physiopathology* ; Ultrasonography, Doppler, Duplex/methods*

Neurogenic erectile dysfunction (NED) caused by pelvic floor surgeries/radiation therapies and associated with Parkinsons disease and diabetes remains a challenging healthcare issue. To facilitate NED research we have developed in vitro and in vivo experimental models. The in vitro model comprises the isolation, culture and treatment of rat major pelvic ganglia (MPG), which then produce outgrowing neurites whose length and molecular composition are indicative of the neurotrophic effect of the treatment agent. Through this approach we have confirmed that the brain-derived neurotrophic factor (BDNF) promotes nerve regeneration by activating the JAK/STAT signaling pathway. This has been further established by our in vivo model, which involves the transection or cruch of cavernous nerves and treatment with BDNF.
Animals ; Disease Models, Animal ; Erectile Dysfunction ; physiopathology ; Ganglia ; physiopathology ; Humans ; In Vitro Techniques ; Male ; Nerve Regeneration ; Pelvis ; innervation ; Penis ; innervation ; physiopathology

Erectile dysfunction (ED) is a common complication of diabetes mellitus. Diabetes mellitus can cause oxidative stress, which plays a key role in the pathogenesis of diabetes-associated ED by acting on blood vessel endothelia, peripheral nerves and smooth muscles and inducing cell apoptosis. Recent progress in the researches on the correlation of oxidative stress with diabetic ED is briefly reviewed in this article.
Animals ; Diabetes Mellitus, Type 2 ; complications ; physiopathology ; Diabetic Neuropathies ; etiology ; physiopathology ; Erectile Dysfunction ; etiology ; physiopathology ; Humans ; Male ; Oxidative Stress ; Rats

OBJECTIVETo determine whether smoking affects the endothelial function of young ED patients with no cardiovascular disease.

METHODSThis study included 69 ED patients (21 smokers and 48 non-smokers) and 16 age-matched normal healthy controls. All underwent measurement of brachial artery flow-mediated vasodilation (FMD) and examinations of blood pressure, cholesterol, triglycerides and glucose.

RESULTSBrachial artery FMD was remarkably decreased in the ED patients, even more significantly in the smokers ([6.0 +/- 0.8]%) than in the non-smokers ([9.7 +/- 2.5]%) (P < 0.05), as compared with that in the normal healthy controls ([14.0 +/- 2. 5]%, P < 0.05).

CONCLUSIONEndothelial function is impaired in ED patients, and is further damaged by smoking.

Adult ; Case-Control Studies ; Endothelium, Vascular ; physiopathology ; Erectile Dysfunction ; physiopathology ; Humans ; Impotence, Vasculogenic ; physiopathology ; Male ; Smoking ; Vasodilation

OBJECTIVETo explore the relationship between aging and erectile function changes in rats in order to establish a rat model of aging-related erectile dysfunction (ED).

METHODSEighty male Wistar rats were equally divided into four age groups (3-, 6-, 12- and 18-month) and treated with intragastric administration of sildenafil citrate (Sn) for penile erection tests. Twenty 3-month-old female Wistar rats were randomized to four groups as oestrous rat models. We recorded the rate and frequency of penile erections of the male rats in different age groups.

RESULTSThe rates of penile erection were 85%, 75%, 40% and 30% and erectile frequencies were 2.27 +/- 0.80, 2.00 +/- 0.61, 1.40 +/- 0.51 and 1.29 +/- 0.49 in the 3-, 6-, 12- and 18-month rats, respectively, with statistically significant differences among different age groups (P < 0.01). And their erectile function exhibited a tendency to decrease with the increase of age. Besides, comparison of the 3-month with the 6-, 12- and 18-month groups showed significantly reduced erectile function in the 18-month rats (P < 0.05) but no remarkable difference between the 3-month and the 6- and 12-month groups (P > 0.05).

CONCLUSIONAging is one of the main risk factors of rat erectile dysfunction, and 18-month-old male rats are qualified for the establishment of the rat model of aging-related erectile dysfunction.

Aging ; physiology ; Animals ; Erectile Dysfunction ; physiopathology ; Male ; Models, Animal ; Penile Erection ; physiology ; Rats ; Rats, Wistar

OBJECTIVETo evaluate the effect of continuous positive airway pressure (CPAP) on erectile dysfunction (ED) in patients with obstructive sleep apnea syndrome (OSAS).

METHODSWe searched Cochrane Library, PubMed, China Academic Journal Full-Text Database, Chinese Biomedical Literature Database, Wanfang Resource Database and Chinese Journal Full-Text Database for clinical trials on the effect of CPAP on ED in OSAS patients. We identified the trials according to inclusion and exclusion criteria, evaluated their quality, and then extracted valid data for meta-analysis.

RESULTSWe included 4 articles, 3 in English and 1 in Chinese, involving 77 cases of OSAS with ED. Meta-analysis revealed no statistically significant heterogeneity among different studies (P = 0.80; I2 = 0%), and therefore the fixed effect model was used for the analysis, which showed a significant increase in the IIEF-5 score after CPAP treatment (WMD = 4.19, 95% [3.01, 5.36], P < 0.001).

CONCLUSIONThe existing evidence from clinical trials shows that the CPAP therapy can significantly improve ED in OSAS patients. However, its efficacy has to be verified by randomized controlled clinical trials of higher quality and larger sample size.

Continuous Positive Airway Pressure ; Erectile Dysfunction ; therapy ; Humans ; Male ; Sleep Apnea, Obstructive ; physiopathology ; therapy ; Treatment Outcome

BACKGROUNDErectile dysfunction (ED) is a common impairment among older men, and the prevalence rates increase sharply after age of 60 years. Most studies have focused on the prevalence rate or dangerous factors. The aim of this study was to investigate the basic epidemiologic data about ED patients with different ED courses. The purpose of this research was to understand the therapeutic effect of phosphodiesterase type 5 inhibitor (PDE5-I) and see how and why the ED course impact the progress of ED and the therapeutic effect of PDE5-I treatment.

METHODSFrom June 2008 to June 2009, 4252 questionnaires (Quality of Erection Questionnaire, QEQ) were gathered from 46 centers by urology or andrology doctors all around China. Patients with ED (age ≥ 20 years) filled in first half of the questionnaires when they came for the first time, and then completed the second half 4 weeks after PDE5-I therapy.

RESULTSED courses of most patients were less than 5 years (< 5 years, 74.0%; 5 - 10 years 20.8%; > 10 years, 5.2%). As ED course increasing, the incidence of the risk factors of ED, such as smoking, drinking, hypertension, diabetes, heart disease and hyperlipidemia also increase (P ≤ 0.01). PDE5-I was effective in improving the quality of sexual activities (P ≤ 0.01). Administration of PDE5-I improves satisfaction, enjoyment and frequency of sexual activities. The longer the ED course, the worse the therapeutic effect (< 5 years, 96.1%; 5 - 10 years, 94.9%; > 10 years, 89.0%) (P ≤ 0.01).

CONCLUSIONSThe ED course greatly affected the therapeutic effect of PDE5-1, the patients with ED should consult doctor at early stage of the disease. Administration of PDE5-I effectively improves the penile erection and the quality of sexual life of the patients hence should be considered as first-line medicine in the treatment of ED.

Adult ; Erectile Dysfunction ; drug therapy ; epidemiology ; physiopathology ; Humans ; Male ; Phosphodiesterase 5 Inhibitors ; therapeutic use ; Surveys and Questionnaires