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

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

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

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

Advanced chronic kidney disease is associated with impaired spermatogenesis and testicular damage. Semen analysis typically shows a decreased volume of ejaculate, oligo- or complete azoospermia, and a low percentage of motile sperm. Erectile dysfunction (ED) is also common in patients with chronic renal failure (CRF) and is observed in excess of 50% of these patients. There have been ongoing improvements in survival and quality of life after renal transplantation. One of the most impressive aspects of successful renal transplantation in the young people is the ability of the male patient to father a child. In this article we first review pathophysiology of reproductive failure in end-stage renal disease (ESRD), then ED in ESRD and its management are discussed, finally sexual function in renal transplant patients and management of ED in these patients are reviewed.
Erectile Dysfunction ; therapy ; Humans ; Kidney Failure, Chronic ; physiopathology ; surgery ; Kidney Transplantation ; Male ; Reproduction

Stem cells (SCs) are undifferentiated cells that are capable of self-renewal and differentiation and that therefore contribute to the renewal and repair of tissues. Their capacity for division, differentiation, and tissue regeneration is highly dependent on the surrounding environment. Several preclinical and clinical studies have utilized SCs in urological disorders. In this article, we review the current status of SC use in benign urological diseases (erectile dysfunction, Peyronie disease, infertility, and urinary incontinence), and we summarize the results of the preclinical and clinical trials that have been conducted.
Erectile Dysfunction/physiopathology/*therapy ; Female ; Humans ; Male ; Outcome Assessment (Health Care) ; Stem Cell Transplantation/*methods ; Urinary Incontinence/physiopathology/*therapy

Tadalafil is an oral phosphodiesterase type-5 inhibitor for male erectile dysfunction (ED). It has been proved to improve erectile function, with safety and effectiveness lasting up to 36 h, allowing patients to choose when to have sexual activities. Tadalafil is also efficacious in the treatment of ED associated with such diseases as hypertension, diabetes mellitus, etc. This article reviews the available evidence for the efficacy of tadalafil on ED and related diseases.
Carbolines ; therapeutic use ; Diabetes Mellitus ; drug therapy ; physiopathology ; Erectile Dysfunction ; drug therapy ; physiopathology ; Humans ; Hypertension ; drug therapy ; physiopathology ; Male ; Phosphodiesterase Inhibitors ; therapeutic use ; Tadalafil ; Treatment Outcome

Erectile function is a typical neurovascular process. Penile vascular endothelial dysfunction is indicated to be one of the important mechanisms of ED. Protective agents to improve penile vascular endothelial function show significant benefits to erectile function by decreasing the damage of oxidative stress and optimizing the related mediators. The protection of penile vascular endothelial function is a new approach to the treatment of ED.
Endothelium, Vascular ; metabolism ; Erectile Dysfunction ; therapy ; Humans ; Impotence, Vasculogenic ; metabolism ; physiopathology ; Male ; Oxidative Stress ; Penis ; blood supply

Phosphodiesterase type 5 (PDE5) inhibitors effectively enhance the erectile function of the patients with erectile dysfunction (ED). The use of sildenafil citrate is expanding to a broader extent. Pulmonary artery hypertension has become a new indication of sildenafil. Sildenafil could improve the epithelial function in several vascular conditions in clinical trials. This article reviews the recent advances on basic and clinical studies of ED and sildenafil. On animal models, sildenafil could resume the cavernous epithelial function, up-regulate the protein expression of phosphorylated endothelial NO synthase (eNOS), reverse the decreased intracavernosal pressure (ICP) induced by pudendal artery blood flow restriction or hypoxia. In clinical studies, over 50% of ED patients receiving sildenafil got a fully rigid erection (grade 4 erection). And the same percentage of post-nerve-sparing radical prostatectomy patients receiving sildenafil obtained penile rehabilitation and spontaneously resumed erection sufficient for sexual intercourse. Sildenafil treatment has contributed to the normalization of self-esteem, confidence and sexual harmony in men with ED. All this suggests that a whole rehabilitation from erectile to psychosocial function may become a new goal of ED therapy.
Animals ; Erectile Dysfunction ; drug therapy ; physiopathology ; rehabilitation ; Humans ; Male ; Mice ; Penis ; drug effects ; physiopathology ; Phosphodiesterase Inhibitors ; therapeutic use ; Piperazines ; therapeutic use ; Purines ; Rats ; Sildenafil Citrate ; Sulfones

Low-intensity extracorporeal shockwave therapy (LI-ESWT) is a novel treatment for erectile dysfunction (ED). With the property of angiogenesis, LI-ESWT acts on vasculogenic ED by improving penile hemodynamics and endothelial function. LI-ESWT is proved to be safe and effective in the treatment of vasculogenic ED in various prospective clinical studies, including randomized, double-blind, and sham-controlled trails. With more multi-centered larger-sample randomized controlled trials, LI-ESWT will play a valuable role in the treatment of ED.
Erectile Dysfunction ; therapy ; High-Energy Shock Waves ; therapeutic use ; Humans ; Male ; Penis ; physiopathology ; Prospective Studies ; Randomized Controlled Trials as Topic ; Ultrasonic Therapy