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
  • 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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