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

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

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

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

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 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

OBJECTIVESTo identify rat cavernous nerve and establish a rat model of erectile dysfunction (ED) caused by injury of cavernous nerve.

METHODSTwenty rats were undergone dissections. Cavernous nerves were identified with the aid of operating microscope and confirmed by electrical stimulation. Then, 42 experimental rats were randomized into 3 groups, including sham operated controls, unilateral and bilateral cavernous nerve ablation groups. Three weeks after surgery, rat models were evaluated with Apomorphine Test.

RESULTSThe major pelvic ganglion lies on either side of the dorsolateral lobes of the prostate. It includes 2 inflows, one called hypogastric nerve and another is pelvic nerve. The largest outflow is termed as cavernous nerve. Stimulus parameters which could induce obvious penile erection were 5 volts, frequency of 20 Hertz and duration of 5 milliseconds. Three weeks after surgery, apomorphine could induce penile erection of each rat in controls with mean (2.57 +/- 1.40) erections in 30 minutes, while there were no erections (0.00 +/- 0.00) either in unilateral or bilateral group.

CONCLUSIONSThe rat of larger ganglion and its cavernous nerve can be easily identified, obvious response to electrical stimulation, low cost of animal purchase, easy housing and availability made rat as an ideal animal for establishing ED model caused by cavernous nerve injury. In addition, our study showed in the early period of cavernous nerve injury, either unilateral or bilateral, all rats lost their erectile function.

Animals ; Erectile Dysfunction ; etiology ; physiopathology ; Male ; Models, Animal ; Nerve Tissue ; injuries ; Rats