Novel predictive risk factor of erectile dysfunction: Serum 25-hydroxy vitamin D

The present study aimed to investigate the association between the severity of erectile dysfunction (ED) and serum 25-hydroxy vitamin D. It also sought to determine the cut-off level of serum 25-hydroxy vitamin D for ED. This study included 130 men who had ED between 2018 and 2019. Patients were divided into three groups according to their scores on the international index of erectile function-5 (IIEF-5) Turkish validated short form questionnaire. The serum 25-hydroxy vitamin D results were compared between the groups. The mean age of the patients was 49.28 ± 13.62 years. Groups 1, 2 and 3 included 44 (33.8%) patients with severe ED, 56 (43.1%) patients with moderate ED and 30 (23.1%) patients with mild ED, respectively. Statistical significance was observed between the groups and serum 25-hydroxy vitamin D levels. A positive correlation was detected between the IIEF-5 scores, serum testosterone and serum 25-hydroxy vitamin D levels. A cut-off level for serum 25-hydroxy vitamin D was calculated as 27.32 ng/ml. During multivariate analysis, we found that serum 25-hydroxy vitamin D levels were independent prognostic risk factors for decreased IIEF-5 scores. Decreased serum 25-hydroxy vitamin D levels were associated with decreased IIEF-5 scores. Therefore, vitamin D replacement therapy may improve symptoms.     

Serum folic acid levels and erectile dysfunction: A meta-analysis and systematic review

The aim of this study was to assess the relationship between serum folic acid (FA) levels and erectile dysfunction (ED) through a meta-analysis. A research was conducted in MEDLINE via PubMed, Cochrane Library, EMBASE and Web of Science up to 22 November 2020 to identify studies related to FA and ED. Two authors independently screened the literature, evaluated methodological quality and extracted the data. We used RevMan5.3 and STATA 14.0 for meta-analysis. A total of six studies including 1,842 participants were included, and the results showed that the FA levels in the non-ED group were significantly higher than those in the ED group (MD = 3.37, 95% CI 1.49–5.52, p = 0.004). Subgroup analysis indicated that with the increase in ED severity, the difference in FA levels between groups was more obvious (MD: 1.99 vs. 4.63 vs. 5.63). The differences in FA levels between groups seem more significant in the younger group (MD = 4.87, 95% CI 2.58–6.89, p < 0.001) than in the older group (MD = 3.15, 95% CI 2.21–4.08, p < 0.001). In conclusion, FA deficiency is closely related to ED, and the degree of FA deficiency may reflect the severity of ED. In addition, the association seems to be more pronounced in the younger group.     

血脂异常与男性勃起功能的相关性研究

目的:探讨血脂异常与男性勃起功能之间的相关关系。　方法:于清晨空腹采集外周血标本,使用生化分 析仪测定其中血清总胆固醇(TC)、总甘油三酯(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)的浓度。从上述 4项结果中至少1项有异常的患者中随机选取200例男性患者,用勃起功能障碍国际指数问卷表(IIEF 5)评估这 些患者的勃起功能,并用统计学方法分析两者之间的相关关系。　结果:血脂异常者勃起功能障碍(ED)的发病率 为47%。年龄、冠心病、空腹血糖水平升高、良性前列腺增生(BPH)、服药、高血压均与勃起功能评分之间呈负相 关,HDL与勃起功能评分之间呈正相关。年龄、冠心病、TC/HDL为ED的危险因素,HDL为保护因素,调整年龄因 素后,冠心病、TC/HDL、BPH均为危险因素,HDL是保护因素。　结论:高血脂是影响男性勃起功能的一个重要因 素。其中HDL水平的下降和TC/HDL比值的上升是ED的重要的危险因素。TC/HDL比值的检测和HDL水平的 检测都是预测ED发生的敏感指标。     

The administration of folic acid improves erectile function and reduces intracavernosal oxidative stress in the diabetic rabbit

OBJECTIVE

To test the possibility that folic acid (FA) may be a means of treating erectile dysfunction (ED) in diabetes mellitus (DM), by studying the effect of FA administration to DM rabbits on cavernosal function and intrapenile oxidative stress.

MATERIALS AND METHODS

To investigate the effect of administering FA to DM rabbits on erectile function and oxidative stress the formation of superoxide (O₂^‐), 8‐isoprostane F_2α (8‐IPF_2α) and prostacyclin (as 6‐keto‐PGF_1α) were assessed, as well as carbachol‐ and electrical field stimulated (EFS) relaxation and p47^phox content (active component of NADPH oxidase complex). Non‐ketotic DM was induced in New Zealand rabbits with alloxan and FA administered orally daily for 1 month. Rabbits were killed, penises excised and segments prepared. These were mounted in an organ bath and relaxation elicited with carbachol or EFS. O₂^‐ release was measured spectrophotometrically, p47^phox expression by Western blotting and 8‐IPF_2α and 6‐keto‐PGF_1α formation by enzyme‐linked immunosorbant assay. Blood was collected for measurement of homocysteine, red blood cell (RBC) folate and glucose.

RESULTS

In cavernosal tissue from DM rabbits, carbachol‐and EFS‐induced relaxation was significantly impaired compared with the untreated controls. O₂^‐ release, p47^phox expression and 8‐IPF_2α formation were all enhanced and 6‐keto‐PGF_1α formation reduced compared with the controls. All these effects were reversed by FA. Plasma total homocysteine was reduced and RBC folate elevated.

CONCLUSIONS

The administration of FA may constitute a strategy for reducing ED in patients with DM.     

他达拉非治疗勃起功能障碍:良好的安全性和耐受性

他达拉非是新型的5型磷酸二酯酶(PDE5)抑制剂,口服用于治疗勃起功能障碍(ED)。在具有卓越的36h疗效的同时,他达拉非治疗ED的安全性和耐受性均十分良好,不良事件多为一过性的轻、中度事件。ED患者往往伴发多种基础疾病或同时需服用多种药物,因此,详细地了解他达拉非在一般人群以及某些特殊的高危人群中的安全性是十分重要的,本文就这方面内容进行了综述。     

勃起功能障碍的药物治疗

近年来,特别是5型磷酸二酯酶抑制剂———西地那非上市以来,众多学者对勃起功能的生物化学和生理学进行了深入研究,在勃起功能障碍(ED)药物治疗的基础和临床方面取得了许多新的进展。本文综述了多种作用于中枢和外周ED治疗药物的分子及细胞作用机制,为最近ED药物研究和进展中最具争议的领域提供一些详细资料。     

勃起功能障碍与血管内皮功能关系的研究进展

血管内皮功能在阴茎勃起过程中扮演了十分重要的角色,血管内皮功能障碍是ED的病理基础之一。测量肱动脉血流介导的血管扩张功能是目前血管内皮功能主要的评估方法。改善血管内皮功能的治疗能改善阴茎勃起功能。ED是心血管疾病的先兆,及早发现ED并给予适当治疗,在改善生活质量的同时有助于降低未来心血管疾病的风险。     

勃起功能障碍基因治疗研究进展

近年来基因治疗被尝试用于勃起功能障碍(ED)治疗的动物实验,许多研究发现基因治疗方案对各种类型的ED均有一定的治疗作用。特别是在左旋精氨酸-一氧化氮-环磷酸鸟苷通路、离子通道、勃起神经和海绵体血管内皮细胞的修复保护等方面的基因治疗研究显示,基因治疗ED有一定的疗效。但应用基因治疗来治疗ED患者,目前仍有较多的困难,暂时无法应用于临床。本综述旨在对该领域的最新研究进展做一个简单的介绍和展望。     

他达拉非在阴茎勃起功能障碍中的疗效评价

他达拉非是一种口服治疗勃起功能障碍的PDE-5抑制剂药物,其作用时间可以维持到服用药物后36h,具有良好的有效性和安全性,并且可以改善由其它疾病导致的勃起功能障碍,本文对他达拉非治疗阴茎勃起功能障碍的疗效进行综述。     

伐地那非治疗难治性勃起功能障碍的最新进展

5型磷酸二酯酶(phosphodiesterase 5,PDE5)在阴茎勃起功能中所起的作用越来越引起人们的关注。环磷酸鸟苷(cGMP)信号通路介导的一氧化氮平滑肌舒张效应是正常勃起功能的必要条件,这个信号通路的下调能引起勃起功能障碍(erectile dysfunction,ED)的许多病理状态,并导致一些慢性疾病的发生。本文回顾了伐地那非治疗ED患者的有效性和安全性。结果表明,伐地那非对于合并异常脂蛋白血症和高血压、糖尿病、抑郁症、前列腺切除术后、外伤性脊髓损伤、西地那非治疗无效、肾移植术后、慢性前列腺炎和早泄的ED患者安全有效,为这些难治性ED患者提供了一种合理的治疗选择。另外,伐地那非还能延长ED患者的勃起时间。     

他达拉非治疗ED的进展

他达拉非是治疗ED的有效药物,大量的研究已经证实了其在ED患者中的临床疗效。相对于西地那非和伐地那非,他达拉非最为显著的特点是它的长效性,接受治疗的ED患者可以在长达36 h的时间窗内自然地达到有效的勃起。他达拉非对患有内科合并症的ED患者具有良好的疗效,它还能有效地改善患者的心理以及晨勃现象,使患者恢复生活的自信。他达拉非的长效性使患者性生活符合“自然、愉快、正常的性生活”这一治疗要求,从而成为越来越多患者的首选药物。     

Tunica Albuginea Reefing: A Novel Technique for the Treatment of Erectile Dysfunction

ABSTRACT

Background: “Tunica albuginea (TA) reefing” is a modification of Shafik's “TA overlapping” operation. Both techniques are based on the fact that in venogenic erectile dysfunction patients, the TA exhibits degenerative and atrophic collagen and elastic fibers causing its subluxation and flabbiness. This had led to loss of the veno-occlusive mechanism of the TA and venous leakage during erection. Aim: Reefing of the redundant tissue by bilateral excision of an ellipse of the TA provides a more effective correction of the TA and achieves a good support of the corpora cavernosa during tumescence. Material and Methods: The study included 24 patients with a mean age of 33.5 ± 1.7 SD years. Intracorporal pressure was measured preoperatively and postoperatively. After penile degloving, an ellipse was excised from both lateral aspects of the penile shaft, extending from the glans penis to its root, and the two edges of each wound were reefed by continuous Dexon suture. Results: The TA ellipses were taken as biopsies and revealed degenerative changes when stained with hematoxylin and eosin and Masson's trichrome stain. Postoperatively, there was an intracorporal pressure increase (p < .01) in 20 out of 24 patients of the study and a decrease in 4 out of 24. Six months after operation, the patients showed significantly (p < .01) improved scores for the domain of erectile function over the preoperative scores. Conclusion: The reefing operation corrects the TA flabbiness to a greater extent, lends more support to corporal tissue, and improves the veno-occlusive mechanism.     

老年性勃起功能障碍的基因治疗

勃起功能障碍(ED)的发病率随着年龄的增长而增高,基因治疗是近年来新兴的一种治疗方法,各种靶基因、不同的载体以及不同的治疗策略用于ED的基因治疗,均取得了一定的治疗效果。本文就老年性ED的基因治疗现状作一综述。     

伐地那非治疗勃起功能障碍的可靠性

疗效的可靠性对于ED患者坚持治疗非常重要。伐地那非是一种强效、高选择性的磷酸二酯酶5(PDE5)抑制剂,其疗效和安全性已得到了大量临床研究的证实。本文分析了伐地那非在临床试验中和实际应用中的疗效可靠性,得出结论认为其在主要的勃起功能参数方面(包括阴道插入、维持勃起、勃起硬度满意度和总体满意度等)能提供可靠的疗效,提高治疗依从性。     

原发动脉性阴茎勃起功能障碍1例报告及文献复习

目的: 探讨阴茎动脉畸形与原发动脉性勃起功能障碍(ED)的关系,提高对原发动脉性ED的认识与诊治水平。　方法: 报告 1例原发动脉性ED患者诊治资料。　结果: 动脉血管造影提示阴茎背动脉直径较细,而双侧阴茎海绵体动脉缺如。行阴茎三件套假体植入术,术后患者可正常勃起。　结论: 原发动脉性ED临床少见,应提高对原发动脉性ED的认识,明确诊断和治疗手段。     

他达拉非治疗勃起功能障碍药效评价

他达拉非是一种新型的5型磷酸二酯酶(PDE5)抑制剂,口服用于治疗勃起功能障碍。本综述主要就他达拉非上市后有关治疗勃起障碍方面的临床研究结果作一全面分析。所有数据表明,他达拉非作为一种长效的PDE5抑制剂拥有令患者满意的治疗效果和良好的耐受性,同时还有不少潜在的药理效果,这些都有利于我们更好的发挥其临床价值。     

他达拉非治疗勃起功能障碍:卓越的36小时疗效

磷酸二酯酶5(PDE5)抑制剂是治疗勃起功能障碍(ED)的一线口服药物,与其他两种PDE5抑制剂(西地那非和伐地那非)相比,他达拉非有着起效快、服用方便和疗效显著的特点,但更为突出的是其较长的血浆清除半衰期带来的36h的持续药效,可以使患者和伴侣能更加自由地安排用药时间。患者和伴侣对他达拉非治疗的高满意度可能主要源于对用药时间顾虑的减少和对性生活时程关注度下降等社会心理收益。同时,他达拉非的安全性和耐受性良好,符合安全、有效、方便的用药原则,使其成为大多数ED患者及其伴侣偏爱的首选用药。     

勃起功能障碍患者性治疗的临床应用研究

目的:探讨ED性治疗的临床应用。方法:在男科门诊用性治疗的方法对ED患者及伴侣进行治疗。参加性治疗的ED患者及伴侣共11对,其中2例患者伴有射精障碍,2例患者伴有性欲减退,1例患者的伴侣患有阴道痉挛。治疗前后通过访谈对患者和伴侣的性关系和整体关系进行评估,用IIEF对患者的性功能包括勃起功能(EF)、性高潮(OF)、性欲(SD)、性交满意度(IS)、总体满意度(OS)进行评估,并在治疗过程中通过观察和访谈分析性治疗存在的问题。结果:11对病例中,有5对病例完成性治疗全过程,1对由治疗师中止治疗,5对中途先后退出。5对完成治疗的病例,患者与伴侣的性关系比治疗前更加满意。IIEF问卷结果除SD外,EF、OF、IS、OS都比治疗前有所提高,尤其是EF的提高最明显。结论:性治疗是有效的治疗ED的方法。性治疗不仅能够改善患者的ED、伴发的其他性功能障碍,以及伴侣的性功能障碍,还能改善患者与伴侣的整体关系。     

中药治疗勃起功能障碍的分子机制

勃起功能障碍(ED)是临床上男性的常见病和多发病,长期以来中药在我国ED治疗中具有重要地位,随着对勃起功能和ED发生机制的认识深入,目前已阐明部分中药治疗ED的作用机制,这对于中药的推广开发利用具有重要作用。     

他达拉非治疗勃起功能障碍的疗效和安全性临床观察(附80例报告)

目的:观察他达拉非对勃起功能障碍(ED)患者临床有效性和安全性。方法:采用自身对照研究方法。80例ED患者服药前后分别接受性视频刺激加实时阴茎硬度测试仪(R igiscan)监测,比较服药前后阴茎头、根部胀大周径,勃起硬度,持续时间的变化。结果:患者服药前后阴茎勃起头、根部硬度,持续时间比较差异有显著性(P<0.05);心理性ED患者比器质性、混合性ED患者提高更加显著(P<0.01)。他达拉非对ED患者的总有效率为82.5%,对心理性、器质性、混合性的ED有效率分别为92.3%、68.7%、58.3%。心理性ED患者的显效率与器质性、混合性ED患者相比差异显著(P<0.05);药物相关的不良事件(头痛头晕11例,消化道不适8例,面色潮红5例,肌肉疼痛2例)多为轻度,且可以自行缓解,不需处理。结论:他达拉非明显改善大多数ED患者勃起功能,不良反应较少,耐受性好。