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 evaluate the erectile function of the patient with premature ejaculation.

METHODSQuestionnaires of Chinese Indes of Erectile Function (CIEF-5) were issued to 522 patients with premature ejaculation.

RESULTSOf the subjects invertigated, 341 (65.33%) claimed to have the problem of ED with premature ejaculation, and 433 (82.95%) scored below standard in CIEF-5. There was significant difference between the two groups.

CONCLUSIONSPremature ejaculation could significantly influence patients' self-esteem about their erectile function and hence their proper scores in CIEF-5. In most of the patients of premature ejaculation with different degres of erectile dysfunction, only a few with significantly low scores in CIEF-5 had premature ejaculation complicated with ED.

Adult ; Aged ; Aged, 80 and over ; Ejaculation ; Erectile Dysfunction ; diagnosis ; physiopathology ; Humans ; Male ; Middle Aged ; Penile Erection

OBJECTIVESTo investigate the influence of aging on male sexual function.

METHODSThe study selected 93 ED patients, aged from 23 to 64, who responded to the International Index of Erectile Function (IIEF) questionnaire. The questionnaire includes 15 items related to male sexual activity, which are organized into 5 domains, namely, erectile function (EF), orgasmic function (OF), sexual desire (SD), intercourse satisfaction (IS) and overall satisfaction (OS). For statistical analysis, ANOVA with DUNCAN test was conducted, and statistical significance was set at P < 0.05. Some other risk factors of ED such as hypertension, diabetes etc. had been excluded.

RESULTSAccording to the age, the subjects were divided into 5 groups. With age increasing, the proportion of moderate and severe in each group increased from 16.17% to 57.14%, whereas EF score decreased from (19.50 +/- 4.64) to (15.27 +/- 5.64), OF score decreased from (6.93 +/- 2.86) to (5.62 +/- 2.94), SD score decreased from (6.33 +/- 1.63) to (4.50 +/- 2.94), IS score decreased from (10.17 +/- 1.94) to (6.93 +/- 2.90), OS score decreased from (5.00 +/- 0.89) to (3.15 +/- 1.84). The tendency took on linearity (P < 0.01). Aging was negatively correlated to above mentioned scores (r = 0.98, P < 0.01).

CONCLUSIONAging could be thought as a risk factor of ED, which is negatively correlated with male's EF, OF, IS, OS and SD scores, furthermore. IIEF questionnaire is a useful tool assessing epidemiology of ED.

Adult ; Age Factors ; Aging ; physiology ; Erectile Dysfunction ; physiopathology ; psychology ; Humans ; Male ; Middle Aged ; Surveys and Questionnaires

OBJECTIVETo explore the correlation between the results of the nocturnal penile tumescence (NPT) test and the efficacy of tadalafil in the treatment of ED.

METHODSA total of 188 ED patients were divided into a normal NPT group (n = 136) and an abnormal NPT group (n = 52) according to the results of the NPT test. All of them were treated with tadalafil at 20 mg 3 times a week. The IIEF-5 score, SEP2, SEP3 and GAQ score were compared between the two groups before and 1 month after the treatment.

RESULTSTadalafil treatment significantly improved IIEF-5 score, SEP2 and SEP3 of both groups of the patients (P < 0.01). Compared with the abnormal NPT group, the normal NPT group showed a remarkable increase in the IIEF-5 score, SEP2, SEP3 (P < 0.05) and GAQ score (P < 0.01).

CONCLUSIONAfter 1 month of tadalafil treatment, the normal NPT group achieved a more significant improvement of erectile function and sexual satisfaction than the abnormal NPT group, suggesting that tadalafil has a better therapeutic effect for ED patients with normal NPT.

Carbolines ; pharmacology ; therapeutic use ; Erectile Dysfunction ; drug therapy ; physiopathology ; Humans ; Male ; Penile Erection ; drug effects ; Tadalafil