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

SS-cream is a topical agent for treating premature ejaculation (PE) which is made with extracts from 9 natural products. We evaluated the efficacy of SS-cream in the treatment of PE. An open pilot study was performed in 186 patients with PE. The mean ejaculatory latency from intromission to ejaculation was 1.5 minutes. Sixty-four of the 186 patients (34.4%) were combined with mild erectile dysfunction in whom penile rigidity was not sufficient to be satisfied in sexual activity. Patients were instructed to apply 0.1 gm. of SS-cream on the glans penis 1 hour before sexual contact and to wash out the cream before sexual intromission. Patients were asked to complete a report form including ejaculatory latency, the degree of satisfaction in the sexual lives of both themselves and their partners, and any adverse effects after each application. One hundred and sixty-six out of 186 patients (89.2%) reported they were satisfied with the application of the SS-cream and the mean ejaculatory latency was significantly prolonged to 10.89 +/- 5.60 minutes. The mean ejaculatory latency was 9.85 +/- 3.58 minutes in 52 out of 64 patients (81.2%) with mild erectile dysfunction. There was no significant difference in the changes of ejaculatory latencies between patients with pure PE and patients with mild erectile dysfunction. Twenty patients (10.8%) claimed to have no changes of ejaculatory latencies after the application of SS-cream. Adverse effects were noted in 11 patients (5.9%), which were mild local irritation symptoms in 7 patients, and delayed ejaculation of more than 30 minutes in 4 patients, the symptoms subsided spontaneously within 4 hours. These results indicate SS-cream is effective in the treatment of PE and also PE combined with mild erectile dysfunction with a few side effects. Further studies on the action mechanisms of SS-cream and a double blind placebo-controlled trial are needed.
Administration, Topical ; Adult ; Drugs, Chinese Herbal/administration & dosage* ; Ejaculation/drug effects* ; Human ; Male ; Middle Age ; Penile Erection/drug effects

SS-cream (Severance Secret cream) is made up of extracts from 9 natural products for treating premature ejaculation (PE). SS-cream has been proved to be effective in the treatment of PE in pilot clinical studies. It has also been found to have a potentiating effect of their erectile capacity in some patients. Therefore, we investigated the pharmacological actions of SS-cream and the extracts of its individual components in rabbit corpus cavernosal smooth muscle to realize the effect of SS-cream on penile erection. Extracts of Bufonis Venenum induced a dose-related contraction of rabbit corpus cavernosal muscle, which was significantly inhibited by phentolamine. Extracts of Caryophylli Flos induced a dose-related relaxation in the muscle strips precontracted with phenylephrine (5 x 10(-6)M; PHE). Caryophylli Flos caused a dose-dependent inhibition of the PHE induced contraction and also inhibited the contractility of Bufonis Venenum. Other extracts, when used individually or in a mixture, induced a dose-related relaxation in the precontracted muscle strips with PHE. SS-cream began to exert a relaxing effect at the concentration of 0.05 mg/ml in the muscle strips precontracted muscle strips with PHE (5 x 10(-6)M); causing dose-dependent relaxation with a maximal effect at 0.2 mg/ml. The relaxation effect of SS-cream was partially inhibited by endothelial disruption and by pretreatment with methylene blue, pyrogallol, atropine, and indomethacin, although they were not statistically significant. The results show that SS-cream has a relaxing effect on cavernosal smooth muscle. And it is partly related with enhancing the NO/cyclic GMP pathway although the relaxation mechanism in detail remains to be elucidated. Therefore, SS-cream may be effective for future treatment of mild erectile dysfunction, in addition to its role for premature ejaculation.
Animal ; Ejaculation/drug effects ; In Vitro ; Male ; Muscle Contraction/drug effects ; Muscle, Smooth/drug effects ; Penile Erection/drug effects ; Penis/*drug effects/physiology ; Plant Extracts/*pharmacology ; Rabbits

OBJECTIVETo study the effect of endogenous carbon monoxide (CO) on the smooth muscle function of the dog penile corpus cavernosum in vitro.

METHODSTissue bioassay was used to measure the corpus cavernosum muscle contraction and relaxation. The production of CO was induced in the corpus cavernosum smooth muscle, and the effect of CO on the penile corpus cavernosum smooth muscle pre-contracted by phenylephrine (PE) was determined.

RESULTSChlorinous hemoglobin could relax the smooth muscle stripes pre-contracted by 10 micromol/L PE. A dose-dependent relaxation was observed. The relaxation responses by 10 -100 micromol/L chlorinous hemoglobin were significant compared with the control group (P < 0. 01). The pretreatment of the muscle stripes with ZnPP-IX or methylthioninium significantly reduced the relaxing effect of chlorinous hemoglobin (P < 0.01).

CONCLUSIONThe relaxing effect of endogenous CO on the smooth muscle of the penile corpus cavernosum depends on the concentration of endogenous CO. The underlying mechanism may involve the pathway from CO to cGMP production.

Animals ; Carbon Monoxide ; physiology ; Dogs ; Dose-Response Relationship, Drug ; Hemin ; pharmacology ; In Vitro Techniques ; Male ; Muscle, Smooth ; drug effects ; physiology ; Penile Erection ; drug effects ; physiology ; Penis ; drug effects ; physiology

OBJECTIVETo investigate the ultrasonographic indexes in the evaluation of complete penile erection after oral administration of sildenafil citrate in men with normal erectile function.

METHODSThe subjects lay supine, with the penis raised upwards, its back clinging to the abdomen. The probe was placed at the base of the ventral side of the penis for longitudinal and transverse section scanning. Observations were made on the corpus cavernosum, deep artery and deep dorsal vein of the penis at the time of flaccidity and complete erection after oral administration of sildenafil citrate, respectively.

RESULTSThe examinations were acceptable to all the subjects both physically and psychologically, and all were completed successfully with no complications. Compared with the flaccid state of the penis, obvious changes were observed in the state of complete erection, including marked increases in the diameter of the corpus cavernosum ([18.57 +/- 2.50] mm, increased by [106.8 +/- 62.1]%), the inside diameter of the deep artery ([1.18 +/- 0.26] mm, increased by [54.9 +/- 29.0]%), the peak systolic velocity ([32.5 +/- 10.7] cm/s, increased by [209.3 +/- 112.9]%), and the systolic acceleration ([5.71 +/- 2.71] cm/s2, increased by [179.3 +/- 138.2]%).

CONCLUSIONOral administration of sildenafil citrate followed by ultrasonography is a new approach to the objective evaluation of penile erection, characterized by convenience, safety, non-invasiveness, non-complication, easy acceptability and easy clinical application.

Adult ; Humans ; Male ; Penile Erection ; drug effects ; physiology ; Penis ; diagnostic imaging ; Piperazines ; pharmacology ; Purines ; pharmacology ; Sildenafil Citrate ; Sulfones ; pharmacology ; Ultrasonography

OBJECTIVETo observe the effectiveness of Bushen Huoxue Decoction in improving the erectile function of male patients with coronary heart disease (CHD) after percutaneous coronary intervention (PCI) with stent implantation.

METHODSEighty male CHD patients after PCI with stent implantation were equally assigned to receive conventional Western medicine (control group) and combination of Western medicine with Bushen Huoxue Decoction (treatment group), both for 3 months. Then we compared the pre- and post-medication IIEF-5 scores between the two groups of patients.

RESULTSCompared with pre-medication, the total IIEF-5 score was significantly increased after 3 months both in the treatment group (8.19 ± 2.87 vs 17.83 ± 4.92, P <0.05) and in the control (7.98 ± 2.96 vs 12.18 ± 3.69, P <0.05), even higher in the former than in the latter group (P <0.05), and so were the scores on the 5 specific items (all P <0.05). The total effectiveness rate was 72.5% in the treatment group, significantly higher than 47.5% in the control (P <0.05). No obvious adverse reactions and events were observed during the treatment in either of the groups.

CONCLUSIONBushen Huoxue Decoction can obviously improve the erectile function and the quality of the sexual life of CHD patients after PCI with stent implantation.

Coronary Disease ; surgery ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Male ; Penile Erection ; drug effects ; physiology ; Percutaneous Coronary Intervention ; Phytotherapy ; Stents

OBJECTIVETo evaluate the application of intracavernous pressure (ICP) monitoring in the electrophysiologic and pharmacologic induction of penile erection.

METHODSThe penile dorsal nerves (DN) of 8 anesthetized adult male rats were isolated and the corpora cavernosa exposed. A heparinized 25-gauge angiocath (intravenous catheter) was inserted into the right corpus cavernosum to monitor the ICP and a 30-gauge needle was inserted into the left corpus cavernosum for intracavernosal drug administration. Penile erection was induced by electrical stimulation of the dorsal nerve (16 Hz frequency, 0.5 ms pulse width, 20 s duration, 4 volts) and intracavernous papaverine hydrochloride injection (0.4 mg). ICP was recorded with the SMUP-PC biological signal process system.

RESULTSIn the anesthetized rats, the baseline level of ICP was (12.3 +/- 3.1) mm Hg and the electrical stimulation of the DN significantly increased ICP[(36.4 +/- 2.3) mm Hg, P < 0.05], which slowly returned to baseline pressure after termination of the electrical stimulation. The intravavernosal administration of papaverine also induced a significant increase in ICP [(28.4 +/- 6.1) mm Hg, P < 0.05].

CONCLUSIONICP monitoring in rats provides a useful scientific tool for in vivo studies of penile erection in experimental rat models. It is of great significance for further studying the physiology of penile erection and the pathogenesis of erectile dysfunction as well as for evaluating the efficacy of novel therapies for erectile dysfunction.

Animals ; Electric Stimulation ; Injections ; Male ; Papaverine ; administration & dosage ; pharmacology ; Penile Erection ; drug effects ; physiology ; Penis ; innervation ; Rats ; Rats, Sprague-Dawley

Androgen has been claimed for so long as a pivotal hormone in regulating male sexual function, acting both at the central and peripheral level. We believe that androgen is indeed the main synchronizer of sexual activity regulating libido and enzymes as nitric oxide synthase (NOS) and phosphodiesterase type 5 ( PDE5) , which are crucial for the erectile process. The main action of androgen is to timely adjust the erectile process as a function manifestation of sexual desire, therefore finalizing erection to sex.
Androgens ; pharmacology ; physiology ; Animals ; Male ; Nitric Oxide Synthase ; metabolism ; Penile Erection ; drug effects ; physiology ; Phosphoric Diester Hydrolases ; metabolism ; Rats

Erectile dysfunction is a common disease of andrology, for which current guidelines recommend oral agents as the first-line therapy. The dopamine agonist apomorphine acts on the central control of penile erection to allow a sublingual preparation to produce a prompt response. It is not contraindicated in patients on nitrate medication for coronary artery disease. The present review describes the pharmacodynamics, action mechanism, efficacy and adverse effects of apomorphine.
Apomorphine ; adverse effects ; pharmacokinetics ; therapeutic use ; Dopamine Agonists ; adverse effects ; pharmacokinetics ; therapeutic use ; Erectile Dysfunction ; drug therapy ; physiopathology ; Humans ; Male ; Penile Erection ; drug effects

OBJECTIVETo observe the safety and efficacy of tadalafil in the treatment of erectile dysfunction in clinical research.

METHODSEighty patients with ED, before and after 20 mg tadalafil administered orally, received respectively the rigiscan examination with aural and visual sexual stimulation at the same time, and then Bphallic circumference variation, stiffness index, duration were compared before and after the treatment.

RESULTSPhallic stiffness index, duration revealed a statistically (P < 0.05) obvious improvement before and after the treatment for all patients. A significant difference (P < 0.01) on the phallic stiffness index, duration were found between the patients with psychogenic ED and others with organic or mixed ED after the treatment. Overall satisfaction with tadalafil was 82.5%. There was an obvious difference on the curative rates between the patients with psychogenic ED (92.3%) and others with organic ED (68.7%) or mixed ED (58.3%). All adverse events (11 cases of headache and dizziness, 8 cases of digestive canal unwell, 5 cases of flushing, 2 cases of back muscle pain) associated with tadalafil were mild and recovered without any treatment.

CONCLUSIONTadalafil improves erectile function significantly in most patients. Adverse reactions are generally transient and mild to moderate in nature.

Adult ; Aged ; Carbolines ; adverse effects ; therapeutic use ; Erectile Dysfunction ; drug therapy ; Humans ; Male ; Middle Aged ; Penile Erection ; drug effects ; Phosphodiesterase Inhibitors ; adverse effects ; therapeutic use ; Tadalafil