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1.
Nora M. Haney Sudha Talwar Prasad K. Akula Amit G. Reddy Geoffroy Sanga Pema Thien V. Ninh Bashir M. Rezk Zahra Heidari Mostafa T. Bouljihad Suresh C. Sikka Vijay John Asim B. Abdel-Mageed Wayne J.G. Hellstrom 《The journal of sexual medicine》2019,16(3):383-393
Background
Previous studies have documented improvement in erectile function after bilateral cavernous nerve injury (BCNI) in rats with the use of pioglitazone. Our group determined this improvement to be mediated by the insulin-like growth factor-1 (IGF-1) pathway.Aim
To eliminate the systemic effects of pioglitazone and evaluate the local delivery of IGF-1 by polymeric microspheres after BCNI in the rat.Methods
Male Sprague–Dawley rats aged 10–12 weeks were assigned at random to 3 groups: sham operation with phosphate buffered saline (PBS)-loaded microspheres (sham group), crush injury with PBS-loaded microspheres (crush group), and crush injury with IGF-1–loaded microspheres (IGF-1 group). Poly(lactic-co-glycolic) acid microspheres were injected underneath the major pelvic ganglion (MPG). IGF-1 was released at approximately 30 ng/mL/day per MPG per rat.Outcomes
Functional results were demonstrated by maximal intracavernosal pressure (ICP) normalized to mean arterial pressure (MAP). Protein-level analysis data of IGF-1 receptor (IGF-1R), extracellular signal–regulated kinase (ERK)-1/2, and neuronal nitric oxide synthase (nNOS) were obtained using Western blot analysis and immunohistochemistry for both the cavernosal tissue and the MPG and cavernous nerve (CN).Results
At 2 weeks after nerve injury, animals treated with IGF-1 demonstrated improved erectile functional recovery (ICP/MAP) at all voltages compared with BCNI (2.5V, P = .001; 5V, P < .001; 7.5V, P < .001). Western blot results revealed that up-regulation of the IGF-1R and ERK-1/2 in both the nervous and erectile tissue was associated with improved erectile function recovery. There were no significant between-group differences in nNOS protein levels in cavernosal tissue, but there was an up-regulation of nNOS in the MPG and CN. Immunohistochemistry confirmed these trends.Clinical Translation
Local up-regulation of the IGF-1R in the neurovascular bed at the time of nerve injury may help men preserve erectile function after pelvic surgery, such as radical prostatectomy, eliminating the need for systemic therapy.Strengths & Limitations
This study demonstrates that local drug delivery to the MPG and CN can affect the CN tissue downstream, but did not investigate the potential effects of up-regulation of the growth factor receptors on prostate cancer tissue.Conclusion
Stimulating the IGF-1R at the level of the CN has the potential to mitigate erectile dysfunction in men after radical prostatectomy, but further research is needed to evaluate the safety of this growth factor in the setting of prostate cancer.Haney NM, Talwar S, Akula PK, et al. Insulin-Like Growth Factor-1–Loaded Polymeric Poly(Lactic-Co-Glycolic) Acid Microspheres Improved Erectile Function in a Rat Model of Bilateral Cavernous Nerve Injury. J Sex Med 2019;16:383–393. 相似文献2.
Hsun Shuan Wang Yajun Ruan Lia Banie Kai Cui Ning Kang Dongyi Peng Tianshu Liu Tianyu Wang Bohan Wang Guifang Wang Alan W. Shindel Guiting Lin Tom F. Lue 《The journal of sexual medicine》2019,16(1):17-26
Background
Erectile dysfunction (ED) caused by pelvic neurovascular injury (PNVI) is often refractory to treatment. In many cases, erectogenic therapy is administered in a delayed fashion.Aim
To evaluate penile hemodynamic effects and histologic changes associated with delayed low-intensity extracorporeal shock wave therapy (Li-ESWT) after PNVI ED in a rat model. We visualized images using immunofluorescence and 3-dimensional imaging of solvent-cleared organs (3DISCO), a novel imaging technique.Methods
A total of 32 Sprague-Dawley male rats aged 12 weeks were divided equally into 4 groups: sham surgery as normal controls (NC), PNVI controls (PC), PNVI with very-low-energy Li-ESWT (PVL), and PNVI with low-energy Li-ESWT (PL). Bilateral cavernous nerve crush and internal pudendal bundle ligation were performed in the 3 PNVI groups. Li-ESWT was administered twice a week for 4 weeks in the PL and PVL groups starting at 4 weeks after PNVI.Outcomes
Intracavernous pressure (ICP) studies (normalized to mean arterial pressure [MAP]) were conducted in all subject animals. After testing, tissue was harvested for immunofluorescence staining and 3DISCO analysis.Results
Mean ICP/MAP was lower in PC animals compared with NC animals (0.37 ± 0.03 vs 0.91 ± 0.03, respectively; P = .001). The ICP/MAP ratio was significantly higher in PVL and PL animals (0.66 ± 0.07 and 0.82 ± 0.05, respectively) compared with PC animals (P = .002 and .001, respectively). Detailed microstructures and trajectories of nerves and vessels were identified with immunofluorescence and 3DISCO. The PC group had lower density of nerves, axons, neuronal nitric oxide synthase–positive nerves, and Schwann cells in the dorsal penis. Animals in the PL group had significantly higher expression of all of these markers compared with PC animals.Clinical Implications
Li-EWST may have utility in the management of severe ED related to PNVI from severe pelvic injury or radical pelvic surgeries, even when administered in a delayed fashion.Strength & Limitations
This study of a severe ED phenotype involved treatment administered in a delayed fashion, which is more consistent with how therapy likely would be delivered in a real-world clinical context. Moreover, because the treatment commenced at 4 weeks after injury, when nerve and tissue atrophy have already occurred, the results imply that Li-ESWT can be used for regenerative therapy. Additional studies on dose optimization and treatment interval are needed to inform the design of human clinical trials.Conclusion
Li-ESWT ameliorates the negative functional and histologic effects of severe pelvic neurovascular injury in a rat model system. 3DISCO provides high-resolution images of neuroanatomy and neural regeneration.Wang HS, Ruan Y, Banie L, et al. Delayed Low-Intensity Extracorporeal Shock Wave Therapy Ameliorates Impaired Penile Hemodynamics in Rats Subjected to Pelvic Neurovascular Injury. J Sex Med 2019;16:17–26. 相似文献3.
Hye Chang Rhim Min Seo Kim Young-Jin Park Woo Suk Choi Hyoung Keun Park Hyeong Gon Kim Aram Kim Sung Hyun Paick 《The journal of sexual medicine》2019,16(2):223-234
Introduction
The efficacy and safety of arginine supplements in erectile dysfunction (ED) remain debatable.Aim
To assess the potential role of arginine supplements on ED as alternatives to phosphodiesterase inhibitors.Methods
Studies published up to April 2018 that evaluated the efficacy of arginine supplements were identified from multiple databases (Google Scholar, PubMed, Medline, Embase, Kiss, DBpia, and Cochrane databases). Studies comparing arginine supplements with placebo or no treatment; focusing only on patients with mild to moderate severity of ED; and presenting outcomes such as improvement rate, International Index of Erectile Function (IIEF) score, and adverse effects were included. Subgroup analysis for arginine alone and arginine in combination with other substances was further conducted to increase interpretability.Main Outcome Measure
The strength of the association between arginine supplements and ED was assessed using relative odds ratios and weighted mean differences with 95% CI.Results
In total, 10 randomized controlled trials met the inclusion criteria, reporting the outcomes of 540 patients with ED. The analysis demonstrated that arginine supplements with dosage ranging from 1,500 to 5,000 mg significantly improved ED compared with placebo or no treatment (odds ratios, 3.37 [1.29, 8.77], P = .01, I2 = 44). Arginine supplements also caused significant improvements in the IIEF subdomain scores of overall satisfaction, intercourse satisfaction, orgasmic function, and erectile function, whereas the IIEF sexual desire score remain unchanged. The adverse effect rate in the arginine-treated group was 8.3%, and that in the placebo group was 2.3%, none of which were severe.Clinical Implications
Arginine supplements can be recommended to patients with mild to moderate ED.Strength & Limitations
The strength of this study is that it is the first meta-analysis to assess the potential role of arginine supplements in ED compared with placebo or no treatment. A limitation is that the treatment dosage and duration varied among studies, which may have contributed to study heterogeneity.Conclusion
The results of our systematic review and meta-analysis provide evidence on the effectiveness of arginine supplements for mild to moderate ED.Rhim HC, Kim MS, Park Y-J, et al. The Potential Role of Arginine Supplements on Erectile Dysfunction: A Systemic Review and Meta-Analysis. J Sex Med 2019;16:223–234. 相似文献4.
Introduction
The relationship between periodontal disease (PD) and erectile dysfunction (ED) is still conflicting.Aim
To investigate whether a link between PD and ED exists, and if so, the degree to which it is significant.Methods
The search strategy included using electronic databases and hand searching works published up to June 2018. MEDLINE via PubMed, EMBASE, Proceedings Web of Science, and Current Contents Connect were searched by 2 independent reviewers. Case-control, cohort, or cross-sectional studies including patients with measures of periodontitis and ED were included in the analysis. Quality assessments and sensitivity analysis of selected studies were performed.Main Outcome Measure
The strength of the association between PD and the prevalence of ED was evaluated.Results
5 case-control studies with 213,076 participants met the eligibility criteria and were included in the meta-analysis. Patients with PD were 2.85-fold more likely to be diagnosed with ED (OR = 2.85, 95% CI = [1.83, 4.46]). Asian men were reported to be 3.07 times more likely to be at greater risk for the prevalence of ED. Moreover, studies with high quality and case-control design showed 2 times higher risk for ED in PD (OR = 2.44, 95% CI = [1.44, 4.14]). However, the present evidence was not robust enough owing to the high heterogeneity and instability in sensitivity analysis.Clinical Implications
Patients with PD may have increased risk of ED, suggesting that dental hygiene should be of concern to clinicians when managing patients with ED.Strength & Limitations
This article includes a large literature search to confirm the evidence that PD increases the occurrence of ED. However, there are several confounders, such as age and the type of ED, that failed to be adjusted and that generate bias and affect the correlation between the incidence of ED and PD.Conclusion
This system review and meta-analysis strengthens the evidence that PD might have important clinical implications for risk stratification of ED.Zhou X, Cao F, Lin Z. Updated evidence of association between periodontal disease and incident erectile dysfunction. J Sex Med 2019;16:61–69. 相似文献5.
6.
Dayron Rodriguez Kai Li Michel Apoj Ricardo Munarriz 《The journal of sexual medicine》2019,16(2):248-256
Introduction
The epidemiology of penile fractures in the emergency setting is not well described.Aim
Examine the incidence, evaluation, management, risk factors predicting surgical repair or hospital transfer, and use of financial resources in patients presenting with penile fractures to the emergency departments (ED) nationwide in the Unites States.Methods
ED visits with a primary diagnosis of penile fractures (International Classification of Diseases, Ninth Edition codes) between 2010-2014 were abstracted from the Nationwide Emergency Department Sample.Main Outcome Measure
Penile fracture incidence, disposition, hospital, and clinical factors which were associated with immediate surgical repair or transfer to another institution, and cost were investigated.Results
8,029 ED visits for penile fracture in the United States were observed, which represents a national incidence of 1.02 per 100,000 male subjects per year. No meaningful trends in incidence were observed over the 5-year period. 63.9% were treated non-surgically or discharged from the ED, 25.7% underwent surgical repair, and 10.3% were transferred to other institutions. Hospital factors which predicted surgical repair included Northeast region, teaching hospital status, trauma hospital status, high volume ED, and urban location. Clinical risk factors which predicted surgical repair included hypertension, smoking, alcohol dependence, drug abuse, erectile dysfunction, hematuria, urethral injury, and urinary retention. Factors leading to patient transfers included non-academic, rural and non-trauma hospitals, low economic income and low emergency department volume. In addition, weekend and spring presentation were associated with higher transfer rates, while summer presentation was associated with surgical repair.Clinical Implications
A large proportion of penile fractures are discharged from the ED, indicating possible health care access disparity.Strengths & Limitations
This is one of the first population-based study of penile fracture incidence, disposition, risk factors which predict surgery or transfer, and cost in the US ED setting. The unexpected high number of discharges may be a result of misdiagnosis; alternatively these data may reveal previously under-reported management patterns in the community.Conclusion
This large retrospective study of penile fractures in the US ED setting demonstrates a stable incidence of penile fractures presenting to the US emergency departments. A quarter of patients undergo immediate surgical repair, 10% are transferred to other institutions and 63.9% of patients are discharged home. The high proportion of ED discharges may be due to access to health care disparities.Rodriguez D, Li K, Apoj M, et al. Epidemiology of Penile Fractures in United States Emergency Departments: Access to Care Disparities May Lead to Suboptimal Outcomes. J Sex Med 2019;16:248–256. 相似文献7.
Arcangelo Barbonetti Settimio D’Andrea Francesca Cavallo Alessio Martorella Sandro Francavilla Felice Francavilla 《The journal of sexual medicine》2019,16(5):624-632
Introduction
Comparative studies on differences in sexual function outcomes between homosexual and heterosexual men are sparse and inconclusive.Aim
To systematically evaluate whether, and to what extent, a statistically significant difference exists in the odds of erectile dysfunction (ED) and premature ejaculation (PE) between homosexual and heterosexual men.Methods
A thorough search of Medline, SCOPUS, CINAHL, and Web of Science databases was carried out to identify case-control studies comparing the prevalence of ED and PE in homosexual and heterosexual men. Methodological quality of the included studies was assessed using the Newcastle-Ottawa Scale. Odds ratios (ORs) of reporting ED and PE were combined using random effect models. The Cochrane Q and I2 tests were carried out to analyze the between-studies heterogeneity. Funnel plots and trim-and-fill analysis were used to assess publication bias.Main Outcome Measures
The relationship between sexual orientation and odds of ED and PE was assessed by calculating pooled ORs with a 95% CI.Results
4 studies included in the quantitative analysis collectively provided information on 1,807 homosexual and 4,055 heterosexual men. The pooled ORs indicated that homosexual orientation was associated with 1.5-fold higher odds of reporting ED (OR = 1.49, 95% CI = 1.03–2.16; P = .04) and 28.0% lower odds of reporting PE in comparison to the heterosexual orientation (OR = 0.72, 95% CI = 0.52–1.00; P = .05). However, a significant heterogeneity among the studies was observed. Funnel plots revealed a possible publication bias only for the ED analysis, where the trim-and-fill test detected a putative missing study. Nevertheless, even when the pooled estimate was adjusted for publication bias, there was a significantly higher risk of ED in the homosexual group (adjusted OR = 1.60, 95% CI = 1.10–2.30; P = .01).Clinical Implications
These findings can drive future studies on sexual needs and concerns of homosexual men, which might not exactly match those of heterosexual individuals.Strength & Limitations
This is the first meta-analysis exploring the differences in the prevalence of ED and PE between homosexual and heterosexual men. However, the results should be interpreted with caution, because their generalization could be hindered by the non-probabilistic nature of the samples, and a measurement bias could result from the use of different non-standardized indicators of sexual dysfunctions.Conclusion
Homosexual orientation is associated with higher odds of ED and lower odds of PE compared with heterosexual orientation. Further studies are warranted to elucidate the clinical significance of these findings and whether they reflect differences in patterns of sexual lifestyle.Barbonetti A, D’Andrea S, Cavallo F, et al. Erectile Dysfunction and Premature Ejaculation in Homosexual and Heterosexual Men: A Systematic Review and Meta-Analysis of Comparative Studies. J Sex Med 2019;16:624–632. 相似文献8.
Introduction
Despite evidence to the contrary, a number of advocacy and self-help groups persist in claiming that internet pornography use is driving an epidemic of erectile dysfunction (ED).Aim
The present work sought to explore whether mere pornography use itself and self-reported problematic use of pornography are related to ED, both cross-sectionally and longitudinally.Methods
A series of 3 samples of sexually active men who also used pornography were collected: a cross-sectional sample of undergraduate men in the United States (n = 147), an online sample of men derived from a larger sample that was matched to U.S. nationally representative norms (n = 297), and a 1-year, 4-wave longitudinal sample of adult men derived from an online convenience sample (Mechanical Turk: time 1, n = 433; time 2, n = 223; time 3, n = 202; time 4, n = 196). Pearson correlations and cross-sectional structural equation models were conducted in each sample. Latent growth curve analyses were conducted in the longitudinal sample.Main Outcome Measure
The primary outcomes of interest were cross-sectional and longitudinal reports of erectile functioning as measured by the International Index of Erectile Functioning 5.Results
Across all 3 samples, there was evidence of a positive, cross-sectional association between self-reported problematic use and ED, but no consistent association between mere use itself and ED. In our longitudinal sample, there were correlations among baseline pornography use, baseline self-reported problematic use, and prospective ED at times 2–4; however, latent growth curve analyses demonstrated no significant relationships between any pornography-related variables and trajectories of ED.Clinical Implications
These results suggest that among non-treatment-seeking pornography users, self-reported problematic use likely is associated with concurrent reports of ED, but that the links between these variables are not directional or causal in nature.Strength & Limitations
This work is the first work to systematically examine the links between self-reported problematic use of pornography and ED, and it did so in a variety of samples, using both cross-sectional and longitudinal methods. Even so, the work relied exclusively on self-report methods, and did not control for medical covariates that may be related to the experience of ED.Conclusion
In conjunction with prior literature, we conclude that there is little or no evidence of an association between mere pornography use and ED, consistent evidence of an association between self-reported problematic use and ED cross-sectionally, and no evidence of causal links between any pornography variables and ED.Grubbs JB, Gola M. Is Pornography Use Related to Erectile Functioning? Results From Cross-Sectional and Latent Growth Curve Analyses. J Sex Med 2019;16:111–125. 相似文献9.
Daniel R. Greenberg Michael T. Richardson Jonathan D. Tijerina Michelle B. Bass Michael L. Eisenberg 《The journal of sexual medicine》2019,16(3):394-401
Introduction
Erectile dysfunction (ED) is a common medical condition that requires high-quality evidence to guide clinical practice; however, systematic reviews (SRs) and meta-analyses (MAs) often vary in quality, raising concerns regarding the validity of their results.Aim
To perform an objective analysis of SRs and MAs in ED treatment and management and to report on the quality of published literature.Methods
A comprehensive search in PubMed/MEDLINE and EMBASE of 12 high-impact urology journals was used to identify relevant publications. 2 authors independently performed searches, screened citations for eligibility, extracted data for analysis, and graded methodologic quality using A Measurement Tool to Assess Systematic Reviews (AMSTAR) criteria.Main Outcome Measures
The main outcome was AMSTAR score, which is a validated tool to evaluate the quality of SRs and MAs.Results
31 publications met inclusion criteria and were included in the analysis. The mean AMSTAR score (± SD) among all publications was 6.5 (±2.2) of 11, reflecting “fair to good” quality. 74.2% of systematic reviews and meta-analyses focused on pharmaceutical therapy for ED, with 51.6% studying the effect of phosphodiesterase-5 inhibitors. Only 1 SR/MA studied intracavernosal injection therapy and vacuum erection devices. No publications studied intraurethral injection therapy or implantable penile prostheses. Although not statistically significant, there has been a trend of increasing quality of SRs/MAs over time (P = .072).Clinical Implication
The methodologic quality of SRs/MAs should be assessed to ensure high-quality evidence for clinical practice guidelines in ED treatment and management.Strength & Limitation
The data showed that methodologic quality of SRs/MAs in the treatment and management of ED is increasing over time. 12 high-impact urology journals were included in our search, which may introduce selection bias in our results.Conclusions
This review highlights a need for increased effort to study second- and third-line treatments for patients who fail oral therapy.Greenberg DR, Richardson MT, Tijerina JD, et al. The Quality of Systematic Reviews and Meta-Analyses in Erectile Dysfunction Treatment and Management Published in the Sexual Medicine Literature. J Sex Med 2019;16:394–401. 相似文献10.
Introduction
Psychosexual counseling may enhance sexual performance outcomes in men with erectile dysfunction (ED) treated with a phosphodiesterase type 5 (PDE5) inhibitor.Aim
To determine the potential long-term effects of cognitive behavioral therapy (CBT) on Pakistani men with ED who had undergone treatment with a PDE5 inhibitor (PDE5i).Methods
In a 15–18-month follow-up, we reassessed a subsample of 20 men who had been treated with either PDE5is (monotherapy group) or CBT + PDE5i (combined group) on 2 dimensions: sexual functioning and mental health functioning.Main Outcome Measure
International Index of Erectile Function was used to assess sexual function, and 2 Mental Health Inventory subscales were used to assess anxiety and depression. A brief semi-structured interview assessed men’s current sexual status and evaluation of their CBT experience.Results
Men in the combined group continued to show improvement on erectile function and several other sexual parameters, whereas men in the monotherapy group showed either no further improvement or a decrement in sexual response parameters. The results did not appear to be related to changes in relationship satisfaction or mental health indices.Clinical Implications
Adjunctive CBT shows long-term benefits in men with ED treated with a PDE5i.Strength & Limitations
Effect sizes were strong, overcoming the small sample size, but attrition may affect the generalizability of the findings.Conclusion
In the first long-term follow-up study of its kind, CBT proved an effective and supportive adjunctive treatment for Pakistani men with ED taking a PDE5i, with benefits extending long after the end of treatment.Khan S, Amjad A, Rowland D. Potential for Long-Term Benefit of Cognitive Behavioral Therapy as an Adjunct Treatment for Men with Erectile Dysfunction. J Sex Med 2019;16:300–306. 相似文献11.
Ioannis Sokolakis Fotios Dimitriadis Pearline Teo Georgios Hatzichristodoulou Dimitrios Hatzichristou Francois Giuliano 《The journal of sexual medicine》2019,16(2):168-194
Introduction
Despite recent promising clinical results, the underlying mechanism of action of low-intensity extracorporeal shockwave therapy (Li-ESWT) for erectile dysfunction (ED) is mostly unclear and currently under investigation.Aim
To systematically identify and evaluate evidence regarding the basic science behind Li-ESWT for ED, discuss and propose a putative mechanism of action, address the limitations, and imply insights for further investigation in the field.Methods
Using Cochrane’s methodologic recommendations on scoping studies and systematic reviews, we conducted a systematic scoping review of the literature on experimental research regarding Li-ESWT for ED and other pathologic conditions. The initial systematic search was carried between January and November 2017, with 2 additional searches in April and August 2018. All studies that applied shockwave treatment at an energy flux density >0.25 mJ/mm2 were excluded from the final analysis.Main Outcome Measure
We primarily aimed to clarify the biological responses in erectile tissue after Li-ESWT that could lead to improvement in erectile function.Results
59 publications were selected for inclusion in this study. 15 experimental research articles were identified on Li-ESWT for ED and 44 on Li-ESWT for other pathologic conditions. Li-ESWT for ED seems to improve erectile function possibly through stimulation of mechanosensors, inducing the activation of neoangiogenesis processes, recruitment and activation of progenitor cells, improving microcirculation, nerve regeneration, remodeling of erectile tissue, and reducing inflammatory and cellular stress responses.Clinical Implications
Improving our understanding of the mechanism of action of Li-ESWT for ED can help us improve our study designs, as well as suggest new avenues of investigation.Strengths & Limitations
A common limitation in all these studies is the heterogeneity of the shockwave treatment application and protocol.Conclusion
Li-ESWT for ED, based on current experimental studies, seems to improve erectile function by inducing angiogenesis and reversing pathologic processes in erectile tissue. These studies provide preliminary insights, but no definitive answers, and many questions remain unanswered regarding the mechanism of action, as well as the ideal treatment protocol.Sokolakis I, Dimitriadis F, Teo P, et al. The Basic Science Behind Low-Intensity Extracorporeal Shockwave Therapy for Erectile Dysfunction: A Systematic Scoping Review of Pre-Clinical Studies. J Sex Med 2019;16:168–194. 相似文献12.
13.
Nhat Minh Nguyen Kang-Moon Song Min-Ji Choi Kalyan Ghatak Mi-Hye Kwon Jiyeon Ock Guo Nan Yin Ji-Kan Ryu Jun-Kyu Suh 《The journal of sexual medicine》2019,16(3):351-364
Introduction
Penile neurovascular dysfunction is a major cause of erectile dysfunction (ED) in diabetic patients, which causes poor response to oral phosphodiesterase-5 inhibitors. Nerve growth factor precursor (proNGF) and its p75 neurotrophin receptor (p75NTR) have been known to be involved in microvascular complications and neurodegeneration.Aim
To examine the role of proNGF and its receptor p75NTR signaling pathway in diabetic ED, and to determine the effectiveness of proNGF neutralizing antibody (proNGF-Ab) in restoring erectile function in streptozotocin (STZ)-induced diabetic mice.Methods
Diabetes mellitus was induced by intraperitoneal injection of STZ (50 mg/kg) into 8-week-old C57BL/6 male mice for 5 consecutive days. At 8 weeks after the induction of diabetes mellitus, the animals were distributed into 3 groups: controls and STZ-induced diabetic mice receiving 2 intracavernous injections of either saline (days ?3 and 0; 20 μL) or proNGF-Ab (days ?3 and 0; 20 μg in 20 μL of saline). We also examined the effect of proNGF-Ab or p75NTR small interfering RNA in primary cultured mouse cavernous endothelial cells, pericytes, and major pelvic ganglion.Main Outcome Measures
Erectile function was measured by electrical stimulation of the cavernous nerve at 2 weeks after treatment, and the penis was then harvested for histologic and biochemical studies.Results
The cavernous expression of proNGF and p75NTR was upregulated under diabetic conditions. Intracavernous injection of proNGF-Ab successfully restored erectile function in diabetic mice, which reach 93–96% of control values. ProNGF-Ab significantly restored cavernous endothelial cell, pericyte, and neuronal cell content, and increased endothelial cell-to-cell junction proteins in the diabetic mice. Under the high-glucose condition, proNGF-Ab or p75NTR small interfering RNA promoted tube formation in mouse cavernous endothelial cells and pericytes, decreased apoptosis of endothelial cells and pericytes, and enhanced neurite sprouting from major pelvic ganglion.Clinical Implications
The ProNGF/p75NTR pathway will be a new therapeutic target for diabetic ED.Strength & Limitations
This is the first study demonstrating the efficacy of the inhibition of proNGF/p75NTR pathway in diabetic ED. Further studies are needed to test whether a different dosing of proNGF-Ab would induce more durable erectile function recovery.Conclusion
Our findings suggest that inhibition of the proNGF/p75NTR signaling pathway is a promising therapeutic strategy for diabetic ED.Nguyen NM, Song K-M, Choi M-J, et al. Inhibition of proNGF and p75NTR Pathway Restores Erectile Function Through Dual Angiogenic and Neurotrophic Effects in the Diabetic Mouse. J Sex Med 2019;16:351–364. 相似文献14.
Paulina M. Merino Patricia Lopez Abril Salinas Carolina Pastene Alex Muñoz Fernando Cassorla Ethel Codner 《Journal of pediatric and adolescent gynecology》2019,32(2):117-121
Study Objective
To compare ovarian function between adolescents conceived using assisted reproductive technology (AcART) and adolescents who were conceived spontaneously (AcSP).Design
Multicenter study of ovarian function in AcART because of male or tubal infertility.Setting
University Hospital.Participants
We evaluated 22 AcART and 53 AcSP at 1-2 years after menarche. The participants were born at term (≥37 weeks of gestation) with normal birth weights (≥2500 g) from singleton pregnancies.Interventions
None.Main Outcome Measures
Differences in ovulation, reproductive hormones, and ovarian morphology.Results
AcART had an older age of menarche than that of AcSP, even after adjusting for maternal age at menarche, gestational age, and birth weight (P = .027). AcART had lower incidence of ovulation (P = .021) and higher luteinizing hormone serum levels (P = .01) than those of AcSP. The incidence of oligomenorrhea and the cycle length were similar between AcART and AcSP. AcART had levels of anti-Müllerian hormone, inhibin B, follicle-stimulating hormone, estradiol, and androgens similar to those of AcSP. The ovarian morphology, ovarian volume, and follicle counts were similar in both groups.Conclusion
AcART had later menarche, lower ovulation rates, and higher luteinizing hormone levels than those of AcSP. Future studies should investigate whether these findings are indicative of a risk of ovarian dysfunction later in life for AcART. 相似文献15.
16.
Capri G. Foy Jill C. Newman Dan R. Berlowitz Laurie P. Russell Paul L. Kimmel Virginia G. Wadley Holly N. Thomas Alan J. Lerner William T. Riley 《The journal of sexual medicine》2019,16(2):235-247
Introduction
Erectile function, an important aspect of quality of life, is gaining increased research and clinical attention in older men with hypertension.Aim
To assess the cross-sectional association between blood pressure measures (systolic blood pressure [SBP]; diastolic blood pressure [DBP]; and pulse pressure [PP]) and (i) sexual activity and (ii) erectile function in hypertensive men.Methods
We performed analyses of 1,255 male participants in a larger randomized clinical trial of 9,361 men and women with hypertension aged ≥50 years.Main Outcome Measures
The main outcome measures were self-reported sexual activity (yes/no) and erectile function using the 5-item International Index of Erectile Function (IIEF-5).Results
857 participants (68.3%) reported being sexually active during the previous 4 weeks. The mean (SD) IIEF-5 score for sexually active participants was 18.0 (5.8), and 59.9% of the sample reported an IIEF-5 score <21, suggesting erectile dysfunction (ED). In adjusted logistic regression models, neither SBP (adjusted odds ratio = 0.998; P = .707) nor DBP (adjusted odds ratio = 1.001; P = .929) was significantly associated with sexual activity. In multivariable linear regression analyses in sexually active participants, lower SBP (β = ?0.04; P = .025) and higher DBP (β = 0.05; P = .029) were associated with better erectile function. In additional multivariable analyses, lower PP pressure was associated with better erectile function (β = ?0.04; P = .02).Clinical Implications
Blood pressure is an important consideration in the assessment of erectile function in men with hypertension.Strengths & Limitations
Assessments of blood pressure and clinical and psychosocial variables were performed using rigorous methods in this multi-ethnic and geographically diverse sample. However, these cross-sectional analyses did not include assessment of androgen or testosterone levels.Conclusions
Erectile dysfunction was highly prevalent in this sample of men with hypertension, and SBP, DBP, and PP were associated with erectile function in this sample.Foy CG, Newman JC, Berlowitz DR, et al. Blood Pressure, Sexual Activity, and Erectile Function in Hypertensive Men: Baseline Findings from the Systolic Blood Pressure Intervention Trial (SPRINT). J Sex Med 2019;16:235–247. 相似文献17.
David Shveiky Loral Patchen Henry H. Chill Marieta Pehlivanova Helain J. Landy 《Journal of pediatric and adolescent gynecology》2019,32(2):135-138
Study Objective
The objective of this study was to describe prevalence and location of obstetric lacerations in adolescents.Design
Retrospective cohort study.Setting
We performed an analysis of the Consortium on Safe Labor database including tertiary care university-affiliated urban hospitals.Participants
All primiparous women who delivered vaginally were included.Interventions
Vaginal and perineal lacerations were compared between age groups 15 or younger, 16-21, 22-34, 35-39, and older than 40 years.Main Outcome Measures
Outcome measures included vaginal, perineal, labial, and periurethral lacerations. χ2 and Fisher exact tests were used as appropriate, with P < .05 considered significant.Results
A total of 9777 patients were included in the analysis. Young adolescents and adolescents had significantly higher rates of labial and periurethral lacerations compared with individuals aged 22-34 years. The prevalence of third- and fourth-degree perineal tears increased with age.Conclusion
Adolescent primiparous women are less likely to have severe perineal obstetric tears, but have higher rates of labial and periurethral tears. 相似文献18.
Sarah M. Wood Andrea McGeary Michele Wilson April Taylor Brenna Aumaier Danielle Petsis Kenisha Campbell 《Journal of pediatric and adolescent gynecology》2019,32(1):32-38
Study Objective
To determine the impact of a multicomponent quality improvement (QI) intervention on Chlamydia trachomatis screening for young women in primary care.Design
Observational cohort analysis.Setting
Urban primary care site providing adolescent primary and confidential sexual health care.Participants
Female adolescents aged 15-19 years.Interventions
From December 2016 to April 2018, we designed and implemented a multiphase QI intervention. The final intervention, beginning March 2017, consisted of the following at all adolescent well visits: (1) dual registration for well and confidential sexual health encounters; (2) urine collection during the rooming process; and (3) electronic health record-based prompts for chlamydia screening.Main Outcome Measures
Annual chlamydia screening rates before and after the intervention, with a goal of achieving a relative increase of 10%.Results
There were 1550 well adolescent encounters from December 2016 to April 2018. The preimplementation chlamydia screening rate among 15- to 19-year-old female adolescents was 312/757 (41.2%) (95% confidence interval, 20.9%-61.5%). Postintervention, this increased to 397/793 (50.0%) (95% confidence interval, 28.6%-71.5%; P < .001). The clinic chlamydia test positivity rate remained stable, at 10.7% and 11.1% in the pre- and postintervention periods, respectively. There was no significant change in median visit length in the pre- (79.2 minutes; interquartile range, 59.5-103.3) and postintervention periods (80.4 minutes; interquartile range, 61.7-102.8; P = .63).Conclusion
This practice-based QI intervention resulted in a statistically significant 21% relative increase in annual Chlamydia trachomatis screening rates among female adolescents, without lengthening median visit time. 相似文献19.
Forgive Avorgbedor Susan Silva Elizabeth Merwin James A. Blumenthal Diane Holditch-Davis 《Journal of obstetric, gynecologic, and neonatal nursing : JOGNN / NAACOG》2019,48(1):69-77