Investigation of erectile dysfunction

British Journal of Radiology (Impact Factor: 2.03). 11/2012; 85(special_issue_1):S69-S78. DOI: 10.1259/bjr/20361140


Erectile dysfunction (ED) represents a common and debilitating condition with a wide range of organic and non-organic causes. Physical aetiologies can be divided into disorders affecting arterial inflow, the venous occlusion mechanism or the penile structure itself. Various imaging modalities can be utilised to investigate the physical causes of ED, but penile Doppler sonography (PDS) is the most informative technique, indicated in those patients with ED who do not respond to oral pharmacological agents (e.g. phosphodiesterase type 5 inhibitors). This review will examine the anatomical and physiological basis of penile erection, the method for performing PDS and features of specific causes of ED, and will also consider the alternative imaging modalities available.

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    • "The prevalence of ED in males under 40 years old is about 1% to 10%, whereas it is 50% in the 40 to 70-year-old group [1,2]. Many pathological factors are associated with ED, including neuropathy, androgen insufficiency, diabetes, and dysphoria [3]. Current management for ED consists of first-line therapy with oral phosphodiesterase type 5 inhibitors (PDE5Is) and second-line therapy using intracavernosal injection (ICI) therapy with vasodilating agents. "
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    ABSTRACT: Although phosphodiesterase type 5 inhibitors (PDE5Is) are a revolution in the treatment of erectile dysfunction (ED) and have been marketed since 1998, they cannot restore pathological changes in the penis. Low-energy shock wave therapy (LESWT) has been developed for treating ED, and clinical studies have shown that LESWT has the potential to affect PDE5I non-responders with ED with few adverse effects. Animal studies have shown that LESWT significantly improves penile hemodynamics and restores pathological changes in the penis of diabetic ED animal models. Although the mechanisms remain to be investigated, recent studies have reported that LESWT could partially restore corpus cavernosum fibromuscular pathological changes, endothelial dysfunction, and peripheral neuropathy. LESWT could be a novel modality for treating ED, and particularly PDE5I non-responders with organic ED, in the near future. However, further extensive evidence-based basic and clinical studies are needed. This review intends to summarize the scientific background underlying the effect of LESWT on ED.
    12/2013; 31(3):208-214. DOI:10.5534/wjmh.2013.31.3.208
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    British Journal of Radiology 11/2012; 85(special_issue_1):S1-S2. DOI:10.1259/bjr/23337502 · 2.03 Impact Factor
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    ABSTRACT: Article presents the latest knowledge on the pathophysiology of erectile dysfunction (ED), the influence of xenoestrogens on ED and fertility in men and the possibilities of the blocking xenoestrogen actions with natural ingredients as well as treatment options for ED with medicinal plants. With the rising phenomenon of ED in the world there is rising a market with ED treatment products. Especially in menu of internet online shops come increasingly to light new natural over the counter products for ED treatment. Sale and use of medicinal plants and their extracts in the treatment of ED is based according to the declaration of the producers first of all on a number of the thousand-year-old traditions in some nations, based on the efficacy and safety of these plants, verified in the healing practice. Aim of this article was to make an extensive review of the scientific and professional literature and to find out which medical plants, sold in the herbal products for ED, was evaluated for efficacy and safety in relevant clinical trials. The review of the literature shows, that by some marketed medicinal plants lack clinical studies, the results of some clinical studies related to the same medicinal plant are controversial and some bring significantly positive effects, but their number is minimal. The future is therefore open to starting the number of new clinical trials testing the medicinal plants in the treatment of ED with possible inclusion of some of these plants in evidence based medicine, if confirming their efficacy and safety.
    Neuro endocrinology letters 01/2013; 34(6):482-97. · 0.80 Impact Factor
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