It is reported that plenty of men,especially the aged,have been bothering in penile erectile dysfunction(ED).There are series of treatments for ED.Oral erectogenic agents have become the first-line treatment options,including drugs that act on the central and peripheral nervous systems,testosterone,traditional Chinese medicine and so on.Sidenafil,apomorphine and yohimbine are the only three oral therapies currently available for the treatment of this disorder.The second therapy includes intracavernosum injection,transurethral medications,transdermal medications etc.Intracavernosum injection of PGE 1 is an effective approach at the present.With the rapid understanding of erectile physiology and etiology of ED and the introduction of new effective oral agents,the future of pharmacotherapy for ED will extend.In this review,we have highlighted the advances in current treatments and therapeutic approaches in male erectile dysfunction.

Objective To evaluate the clinical value of laparoscopic uItrasonography ( LUS) in u-rinary laparoscopic surgery .Methods In 6 cases of urological laparoscopic surgery , laparoscopic ultra-sound examination were taken , including 3 cases of simple renal cysts , 1 case of adrenal pheochromocyto-ma, 2 cases of hamartoma , were excised under the LUS guidance and the results were compared with the traditional simple laparoscopic surgery .Results With laparoscopic uItrasonography guidance , the bounda-ry and blood supply of cyst or tumor could be shown more clearly compared with trans -abdominal ultrasound . We could differ the tumors from dilated pelvis and renal calices , So the damage to the collecting system and renal blood vessels were avoided .With LUS guidance , tumors were excised more completely , so that re-mained tumor tissues would be avoided and normal renal tissues would be protected .Conclusion LUS may provide more precise surgical information and may play an important role guiding laparoscopic operation in urinary surgery .

Objective　To investigate the feasibility of applying transvescal approach laparoendoscopic single-site radical prostatectomy (TVSSLRP) and assess the oncological and functional outcomes.Methods　Eight patients with clinically localized prostate cancer (PCa) of low risk underwent TVSSLRP.Demographic data were accrued including patient age,body mass index (BMI),preoperative PSA level,the International Index of Erectile Function 5,biopsy Gleason score,clinical TNM stage and D'Amico risk classification.One surgeon performed all TVSSLRP procedures.A homemade triple-port was introduced percutaneouly into the bladder to establish pneumovesicum through a 4 cm incision.The major steps of the surgery were described as follows:initial incision was made along posterior margin of the bladder neck to expose bilateral vas deference and spermatic vesicle.After opening Denonvilliers' fascia and extending the space to lateral prostatic pedicles,an intra-fascial nerve sparing procedure was performed.The puboprastatic ligaments were then separated close to the prostate surface and the dorsal vein complex was cautiously swept off.Subsequently,careful apical dissection and urethral transection was sequentially conducted. To reduce the tension of vesico-urethral anastomosis,3 additional incisions parallel to vesio-urethral margin were created and a novel tension - reduced V-LocTM barbed polydioxanone sutures was used.　Results　All the operations were successfully performed and there was no conversion to standard laparoscopic approach or open surgery.The total operative time range was 75 - 180 min with mean time of 125 min.The blood loss was 85 -450 ml with mean 140 ml and no blood transfusion was required.The catheter was removed after a mean (range) of 14 (9 -16) days.No intra-operative complications occurred. No patient had positive surgical margins.The mean (range) hospital stay was 17 (13 -25) days after surgery. All the cases were continent after removal of the catheter.No cases demonstrated vesico-urethral stricture and biochemical recurrence on 12 - 18 months follow up postoperatively.　Conclusions　TVSSLRP is technically feasible for cases with organ-confined prostate cancer with good oncological and functional results.

OBJECTIVETo investigate the effects of the metabolite produced by Trichomonas vaginalis on human sperm motility in vitro.

METHODSTrichomonas vaginalis having been cultured, the culture solution containing metabolite was obtained by removing the protozoa, then diluted into 3 kinds of concentration. Sperm was obtained from 10 healthy fertile men by masturbation and prepared by swim-up technique to produce a spermatozoon solution of high motility. Every sperm sample was divided into 4 groups (A, B, C, D). Unused culture solution was added to Group A as control, and the other 3 groups (B, C, D) were respectively incubated with the above used culture solution at 3 kinds of concentration (1.2 x 10(9)/L, 6 x 10(8)/L, 1.2 x 10(8)/L). Measurements were carried out at 30 s, 1 h, 2 h, 4 h, 6 h by CASA.

RESULTSSperm motility decreased in both Group B and C markedly, and the effects displayed a concentration- and time-dependent manner.

CONCLUSIONThe metabolite of Trichomonas vaginalis can reduce human sperm motility in vitro, and may be one of the causes of infertility.

Animals ; Dose-Response Relationship, Drug ; Humans ; Male ; Sperm Motility ; drug effects ; Time Factors ; Trichomonas vaginalis ; metabolism

To investigate the role of ligustrazine on relaxation of the isolated rabbit corpus cavernosum tissue in vitro, the effects of ligustrazine on the corpus cavernosum were observed by using experimental method of smooth muscle strips. Concentration-responses to phenylephine (PE) and KCl were recorded. The results showed that ligustrazine concentration-dependently depressed the contraction response of smooth muscle strips induced by PE. The maximum percentage relaxation of cavernosal strips by ligustrazine was 74.1% ±6.2 % (compared with control: 21.9 % ±5.6 %, P ＜0.01). Ligustrazine concentration-dependently reduced the amplitude of the contraction induced by cumulative doses of PE or KCl, shifted the cumulative concentration response curves of PE and KCl to the right and depressed their maximal responses. It was concluded that ligustrazine could significantly relax the cavernosal muscle contraction induced by PE in vitro. The results suggested that ligustrazine inhibited calcium ion influx.

OBJECTIVETo investigate the effects of chuanxiongzine on the relaxation of isolated rabbit corpus cavernosum tissues.

METHODSObservations were made on the relaxing effect of chuanxiongzine on phenylephrine (PE)-precontracted corpus cavernosum and cavernosal strips preincubated with L-NAME, and ODQ, using endothelium removal and experimental method of smooth muscle strips. The effect of chuanxiongzine on cAMP and cGMP levels in corpus cavernosum was measured by 125I radioimmunoassay.

RESULTSChuanxiongzine had concentration-dependent relaxing effect on the cavernosal muscle contraction induced by PE (EC50 1.58 x 10(-4) mol/L). This relaxing effect was partially antagonized by ODQ and not blocked by L-NAME or endothelium removal. In PE-precontracted cavernosal strips, chuanxiongzine induced relaxation accompanied with an increase in cAMP and cGMP levels.

CONCLUSIONChuanxiongzine was effective in relaxing cavernosal muscle precontracted by PE in vitro. And its relaxing effect may be enhanced by increasing cGMP and cAMP levels in the corpus cavernosum.

Animals ; Cyclic AMP ; metabolism ; Cyclic GMP ; metabolism ; Dose-Response Relationship, Drug ; In Vitro Techniques ; Male ; Muscle Relaxation ; drug effects ; Muscle, Smooth ; drug effects ; physiology ; Penis ; drug effects ; physiology ; Pyrazines ; pharmacology ; Rabbits

OBJECTIVETo investigate the clinical characteristics of female clitoral priapism.

METHODSA 29-year-old case of painful priapism of the clitoris lasting 60 hours was reported. The etiology, diagnosis and treatment of clitoral priapism were discussed and the literature reviewed.

RESULTSThe patient was cured by intracavernous administration of adrenaline.

CONCLUSIONClitoral priapism is extraordinarily rare. It is primarily due to oral antidepressant drugs or pelvic malignant neoplasm which leads to tissue infiltration of the clitoral veins and obstruction of the clitoral corporeal blood flow. The efficient therapeutic approach to clitoral priapism is intracavernous administration of alpha-agonists similar to the treatment of penile priapism.

Adult ; Clitoris ; anatomy & histology ; physiology ; Female ; Humans ; Vulvar Diseases ; etiology ; therapy

Purpose: The poor retention and ambiguous differentiation of stem cells (SCs) within corpus cavernosum (CC) limit the cell application in erectile dysfunction (ED). Herein, the effects and mechanism of microRNA-145 (miR-145) gene modification on modulating the traits and fate of bone marrow-derived mesenchymal stem cells (BMSCs) were investigated. Materials and Methods: The effects of miR-145 on cell apoptosis, proliferation, migration, and differentiation were determined by flow cytometry, cell counting kit-8, transwell assays and myogenic induction. Then, the age-related ED rats were recruited to four groups including phosphate buffer saline, BMSC, vector-BMSC, overexpressed-miR-145-BMSC groups. After cell transplantation, the CC were harvested and prepared to demonstrate the retention and differentiation of BMSCs by immunofluorescent staining. Then, the target of miR-145 was verified by quantitative real-time polymerase chain reaction and immunohistochemical. After that, APTO-253, as an inducer of Krüppel-like factor 4 (KLF4), was introduced for rescue experiments in corpus cavernosum smooth muscle cells (CCSMCs) under the co-culture system. Results: In vitro, miR-145 inhibited the migration and apoptosis of BMSCs and promoted the differentiation of BMSCs into smooth muscle-like cells with stronger contractility. In vivo, the amount of 5-ethynyl-2′-deoxyuridine (EdU)+cells within CC was significantly enhanced and maintained in the miR-145 gene modified BMSC group. The EdU/CD31 co-staning was detected, however, no co-staining of EdU/α-actin was observed. Furthermore, miR-145, which secreted from the gene modified BMSCs, dampened the expression of KLF4. However, the effects of miR-145 on CCSMCs could be rescued by APTO-253. Conclusions Overall, miR-145 modification prolongs the retention of the transplanted BMSCs within the CC, and this effect might be attributed to the modulation of the miR-145/KLF4 axis. Consequently, our findings offer a promising and innovative strategy to enhance the local stem cell-based treatments.