勃起功能障碍和心血管疾病

勃起功能障碍（erectile dysfunction,ED)是中老年男性的常见疾病。ED是血管病,因为它的常见发病机制是内皮功能障碍和一氧化氮（NO）生成障碍。这与其它常见血管疾病,尤其是动脉粥样硬化疾病的发病机制相同。     

心血管疾病与勃起功能障碍相关研究的文献计量学分析

[目的]分析勃起功能障碍和心血管疾病研究领域的研究现状和趋势,为后续研究提供依据。[方法]通过Scopus数据库检索勃起功能障碍和心血管疾病领域的所有文献,分析其发表年份、文献类型、国家/地区分布、研究机构分布、被引情况、研究者合著关系及标题信息,对近年来该领域的研究情况进行初步了解。[结果]近60年来,基于勃起功能障碍和心血管疾病相关性的研究以原始论著研究为主,其发文量呈逐年上升的趋势,并在近10年内达到稳定。[结论]西方国家(尤其是美国和意大利)在勃起功能障碍和心血管疾病研究领域处于领先地位,临床研究和流行病学研究是该领域的研究热点,同时该研究领域内的研究人员间存在密切的合作关系。     

心血管病患者勃起功能障碍与西地那非治疗

男性心血管病患者容易发生勃起功能障碍(erectiledysfunction,ED),俗称阳萎。ED按美国国立卫生研究院(NIH)及美国泌尿系疾病学会(AUA)的定义,是指男性阴茎不能达到或维持勃起以完成满意的性交。它对许多男性生活质量及其家庭生活有重要的影响。 各种程度ED与老龄化密切相关。据1994年美国麻省一项对40～70岁男子的调查(MMAS),40岁时ED为39％,70岁时达到67％,但年龄并非是ED发生率高的唯一原因。很多危险因素包括动脉粥样硬化(AS)、高血压、心血管病(CVD)(由于动脉粥样硬化及/或高血压居多数)、糖尿病、精神抑郁、盆腔放射治疗或外科手术、脊柱损伤、吸烟、嗜酒、吸毒等都有影响。性生活与心血管病之     

糖尿病勃起功能障碍的研究进展

勃起功能障碍(erectile dysfunction，ED)通常指男子在性刺激下，持续的或反复不能达到或维持足够阴茎勃起以完成满意性交，是男性糖尿病(diabetic mellitus，DM)常见的并发症之一。糖尿病患者中ED的发生率高达30％-70％，比非DM患者高2～5倍，且随年龄和病程的增长发生率明显增加。本文就近年来糖尿病ED的研究进展作一综述。     

男性勃起功能障碍

“勃起功能障碍”一带有贬意的“阳痿”一词。有资料表明，４０－７０岁男性约有５２％患有不同程度的勃起功能障碍，但只有１０％的病人录求治疗。近二十年来，勃起的生理和病理研究逐渐深入。随着尿道给药（Ｍuse）和口服药（Ｖiagra）的推出，新的治疗方法更简便、有效、安全；诊断方法也以病人的目标为导向。     

输精管结扎术后勃起功能障碍的调查研究

目的探讨男性输精管结扎术后患者并发勃起功能障碍的情况。方法对诊断为输精管结扎术后勃起功能障碍的患者采用国际勃起功能问卷表-5(IIEF-5)及一般资料调查表进行问卷调查,对其性欲、勃起功能、性交频率和持续时间等数据采用SPSS 15.0统计软件进行处理并分析结果。结果本次研究对216例受术者进行综合测评,发生勃起功能障碍的共46例,占总调查例数的21.3%,其中轻度障碍的患者24例(占52.2%),轻度到中度障碍的患者13例,(占28.2%),中度障碍的患者8例(占17.4%),严重障碍的患者1例(占2.2%)。结论并发症发病率较高,且与年龄成正相关,在以后的治疗中应加强教育,规范治疗方案,严格执行适应症要求,减少输精管结扎术对患者的生活影响,提高我院的经济和社会效益。     

早泄与勃起功能障碍

早泄(premature ejaculation,PE)和勃起功能障碍(erectile dysfunction,ED)是成年男性中最常见的性功能障碍性疾病.其中PE的发病率为25%～40%,ED的总发病率约为40%～52%[1].两者之间在病因、发病机制、诊断及治疗等方面有共同之处,近年来随着对男性勃起机制认识的加深和新的治疗手段的出现,PE和ED的诊疗有了较大的进展.     

重视勃起功能障碍的诊治

勃起功能障碍(erectile dysfunction,ED)是一种男科常见疾病,但是在临床实践中,男科医生所接诊的ED患者"并不常见",ED患者也并不一定在男科门诊就诊,因此,ED患者的就诊率远没有通过问卷调查得到的发病率那样高.     

勃起功能障碍的诊治进展

勃起功能障碍(erectile dysfunction，ED)的概况 ED指的是阴茎不能达到与保持勃起，以至不能完成满意的性交。ED是一种能够治疗的医学状态，并不一定是衰老过程中不可避免的部分。国内有关资料显示，55岁以下ED约占7％，而60岁以上可达18％～75％。     

勃起功能障碍的诊断现状

勃起功能障碍(Erectile Dysfunction,ED)是指过去3个月中,阴茎持续不能达到和维持足够的勃起以进行满意的性交.ED是一种男性最常见的性功能障碍疾病,其患病然很多,但寻求医生诊治的患者仍不到10%.     

Erectile dysfunction and subsequent cardiovascular disease

Context  The risk factors for cardiovascular disease and erectile dysfunction are similar. Objective  To examine the association of erectile dysfunction and subsequent cardiovascular disease. Design, Setting, and Participants  Men aged 55 years or older who were randomized to the placebo group (n = 9457) in the Prostate Cancer Prevention Trial at 221 US centers were evaluated every 3 months for cardiovascular disease and erectile dysfunction between 1994 and 2003. Proportional hazards regression models were used to evaluate the association of erectile dysfunction and cardiovascular disease. In an adjusted model, covariates included age, body mass index, blood pressure, serum lipids, diabetes, family history of myocardial infarction, race, smoking history, physical activity, and quality of life. Main Outcome Measures  Erectile dysfunction and cardiovascular disease. Results  Of the 9457 men randomized to placebo, 8063 (85%) had no cardiovascular disease at study entry; of these men, 3816 (47%) had erectile dysfunction at study entry. Among the 4247 men without erectile dysfunction at study entry, 2420 men (57%) reported incident erectile dysfunction after 5 years. After adjustment, incident erectile dysfunction was associated with a hazard ratio of 1.25 (95% confidence interval [CI], 1.02-1.53; P = .04) for subsequent cardiovascular events during study follow-up. For men with either incident or prevalent erectile dysfunction, the hazard ratio was 1.45 (95% CI, 1.25-1.69; P<.001). For subsequent cardiovascular events, the unadjusted risk of an incident cardiovascular event was 0.015 per person-year among men without erectile dysfunction at study entry and was 0.024 per person-year for men with erectile dysfunction at study entry. This association was in the range of risk associated with current smoking or a family history of myocardial infarction. Conclusions  Erectile dysfunction is a harbinger of cardiovascular clinical events in some men. Erectile dysfunction should prompt investigation and intervention for cardiovascular risk factors.      

Erectile dysfunction, sildenafil and cardiovascular risk

Cardiovascular risk factors are commonly associated with erectile dysfunction and should be identified and treated. Patients with cardiovascular diseases should be assessed and counselled regarding their fitness for sexual activity. The danger of concurrent use of sildenafil and nitrates under any circumstances, regardless of age and sex, must be highlighted at all levels of the community. Sildenafil is absolutely contraindicated in patients receiving treatment with long-acting nitrates for ischaemic heart disease. Patients who need sublingual short-acting nitrates infrequently should not be precluded from taking sildenafil, provided they are aware that sildenafil is not to be taken within 24 h of taking the nitrate.     

Erectile dysfunction

With phosphodiesterase inhibitors, a safe and effective oral therapy has emerged for erectile dysfunction. Increasing awareness, particularly through the media, is inducing more men to seek help for this condition. Erectile dysfunction is defined as the persistent inability to achieve or maintain an erection adequate for satisfactory sexual activity. The prevalence increases with age. Basic and clinical research is identifying the neurovascular and humoral control of the mechanisms. The initial evaluation should differentiate erectile dysfunction from premature ejaculation and loss of libido. Myocardial insufficiency, hypogonadism and peripheral neuropathy should be looked for. Initial laboratory investigations should be restricted to identifying previously undetected medical illness that may directly contribute to erectile dysfunction. Discussing the available options with the couple is an important aspect. If erectile dysfunction is secondary to other treatable disorders these should be treated simultaneously. When other diseases that require intervention are ruled out and if there are no contraindications, therapy may be initiated with a phosphodiesterase inhibitor. In selected cases, psychosexual therapy may be beneficial. If phosphodiesterase inhibitors are contraindicated, vacuum constriction devices may be tried. Further options include intracavemosal injection, intraurethral instillation, penile revascularization and prosthesis. The availability of effective and well-tolerated oral medications has dramatically changed the clinical approach to erectile dysfunction. Pharmacotherapy is the preferred cost-effective first-line therapy in the vast majority of patients. A stepped-care approach is followed in the primary care and family practice settings. Appropriate urological, endocrine and psychiatric referrals, and shared decision-making with the couple will enable effective treatment of men with erectile dysfunction.     

Erectile dysfunction

Erectile dysfunction (ED) is a common condition and can usually be managed pharmacologically, with drugs delivered by intracavernosal injection (ICI), transurethrally or orally. The cardiovascular status of the patient and his overall fitness for renewed sexual activity must be assessed before treatment for ED is initiated. The efficacy of sildenafil is related to the extent and severity of ED, and is significantly reduced in patients with severe vasculogenic ED, ED associated with diabetes and after radical prostatectomy. Alprostadil (prostaglandin E1) is the drug of first choice in patients treated with ICI; it is effective in 72.6% of men with ED and is associated with a low risk of priapism and cavernosal fibrosis. Transurethral alprostadil is significantly less effective than alprostadil ICI, producing improved erections in 30%-40%, but rigid erections in only 10%, of men with ED. There is Level II evidence that: alprostadil ICI is an effective treatment for ED papaverine ICI is associated with a high risk of cavernosal fibrosis and priapism papaverine ICI should be restricted to informed patients refractory to treatment with alprostadil ICI transurethral alprostadil is less effective than alprostadil ICI sildenafil is an effective treatment for ED.     

Erectile dysfunction

A 63 year old man comes to you for a routine check of hisblood pressure.During the consultation you notice an entry in hisnotes about difficulty with erections that was never followed up.What issues you should coverIs this an ongoing problem?-Healthcare professionalsoften fail to initiate discussion of possible erectile dysfunction,whether because of embarrassment,lack of knowledge,orpressure of time.Patients find it even more difficult to raise theissue with their doctors,even though erectile dysfunction can     

Erectile dysfunction in diabetic patients

Erectile dysfunction (ED) appears to be highly prevalent in diabetic patients (around 50% at 50 years of age) and more severe than in the rest of the population. Its etiology is multifactorial in this subset of patients. ED is highly correlated to multiple vascular risk factors and can be considered as a manifestation of endothelial dysfunction in general, alerting the physician to look at underlying silent coronary bed atherosclerosis. It is also dependent on the poor control of diabetes and on the presence of its chronic complications. Because of the multiple etiologies of ED in diabetics, a multifactorial approach is warranted to get an optimal response in treating such patients: diabetes control, use of phosphodiesterase 5 inhibitors, psychosexual counseling, and choice of antihypertensive medications.