M Arafa

Cairo University, Cairo, Muhafazat al Qahirah, Egypt

Are you M Arafa?

Claim your profile

Publications (9)18.76 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Late-onset hypogonadism (LOH) or age-associated testosterone deficiency syndrome is defined as a clinical and biochemical syndrome associated with advancing age and characterised by symptoms and a deficiency in serum testosterone levels. This condition may result in significant detriment in the quality of life and adversely affect the function of multiple organ systems. It has been suggested that sex steroid hormones may play a causal role in the development of insulin resistance and type II diabetes. This comparative study was aimed at determining the prevalence of LOH in diabetic men with erectile dysfunction and investigating the effect of testosterone replacement therapy on erectile function and on glycaemic control.
    Andrologia 12/2011; 44 Suppl 1:756-63. · 1.55 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To evaluate the efficacy, safety and patients' preference of different treatment modalities of ED in men with SCI. Sixty SCI men with ED were included in the study. They were divided into three groups. Group A received sildenafil, group B received intracorporal injection (ICI) and were then shifted to sildenafil and group C used vacuum constriction devices (VCD) and were then shifted to sildenafil. Erection was evaluated before and after each treatment. Ninety percent of patients reported improvement of erection after sildenafil and ICI treatment according to IIEF-EF and only 70% of patients reported improvement in erection with VCD. However, 14 patients reported that they preferred sildenafil due to the easier route of administration. In men with SCI, sildenafil is the most effective treatment and is widely accepted. ICI, VCD therapy in SCI patients should be used according to patient's preference and choice.
    International journal of impotence research 01/2008; 20(2):181-7. · 2.73 Impact Factor
  • Mohamed Arafa, Rany Shamloul
    [Show abstract] [Hide abstract]
    ABSTRACT: Our report describes the construction and evaluation of the Arabic Index Premature Ejaculation (AIPE) as a diagnostic tool for premature ejaculation (PE) and presents data supporting its validity. Seventy-one men complaining of PE and 73 healthy subjects were asked to complete the seven-question AIPE. Diagnosis of PE was based on the criteria set by the second consultation on sexual dysfunctions. The seven items selected were based on assessment of erectile function, sexual desire, ejaculation latency, ejaculation control, patient satisfaction, partner satisfaction, and psychological distress. The AIPE was examined for sensitivity, specificity, and construct validity. A receiver operating characteristic curve indicated that the AIPE is an excellent diagnostic test. A cutoff score of 30 (range of scores 7-35) discriminated best (sensitivity = 0.98, specificity = 0.88). Severity of PE ranged from none (31-35) to severe (7-13). A high kappa value (0.85) indicated existence of significant agreement existed between the predicted and "true" PE classes. AIPE shows a potential to be a reliable aid to decrease the number of misdiagnosed cases of PE.
    Journal of Sexual Medicine 12/2007; 4(6):1750-6. · 3.51 Impact Factor
  • Source
    Mohamed Arafa, Rany Shamloul
    [Show abstract] [Hide abstract]
    ABSTRACT: This study reports the results of a large prospective single-blinded clinical trial of 3 SSRI (paroxetine, fluoxetine and escitalopram) in PE using a validated questionnaire. A total of 100 normally potent men suffering from PE were enrolled in a randomized single-blinded comparative study of fluoxetine, paroxetine and escitalopram Patients were randomized into 3 treatment groups. Group 1 comprised 33 men who received fluoxetine 20 mg daily, group 2 comprised 37 men who received escitalopram 10 mg and group 3 comprised 30 men who received paroxetine 20 mg daily. All drug regimens were given in early morning dose and continued for 4 weeks. All 100 (100%) patients experienced a significant increase in their AIPE total score after drug treatment. There was no significant difference regarding any of the 7 items of the AIPE between the 3 treatment groups. All 3 drugs were generally well tolerated. Our relatively large study, using a validated questionnaire confirmed similar useful effect of paroxetine, fluoxetine and escitalopram on ejaculation time. Further large cohort studies with long-term follow up are needed to evaluate the sustained effects of these drugs on ejaculation latency.
    Therapeutics and Clinical Risk Management 09/2007; 3(4):527-31. · 1.34 Impact Factor
  • Mohamed Mostafa Arafa, Wael Ahmed Zohdy, Rany Shamloul
    [Show abstract] [Hide abstract]
    ABSTRACT: The aim of this study was to evaluate the efficacy of prostatic massage (PM) as a method for obtaining semen in men with spinal cord injury (SCI) and to evaluate the semen parameters in the semen samples obtained by this method. Sixty-nine patients with SCI underwent PM as a trial for semen retrieval. History taking, examination and hormonal assay analysis (follicle-stimulating hormone, luteinizing hormone, prolactin and testosterone) were performed in all patients. Patients were grouped as follows: group 'A' where sperm could be successfully retrieved by PM and group 'B' where no sperm could be retrieved. PM resulted in the production of prostatic secretion in 51 patients (73.9%) and no secretion was obtained in 18 patients. Spermatozoa were successfully retrieved in only 22 patients (31.9%). The semen analysis of the sperm-positive samples showed asthenoteratozoospermia with decreased vitality and increased number of leucocytes. Semen collection by PM was significantly higher in patients with an SCI level above T10. PM is a safe and simple outpatient clinic procedure that can be easily used to retrieve semen in men with SCI.
    International Journal of Andrology 07/2007; 30(3):170-3. · 3.37 Impact Factor
  • Source
    Mohamed Arafa, Hazem Eid, Rany Shamloul
    [Show abstract] [Hide abstract]
    ABSTRACT: Recently, it was reported that phentolamine redosing during penile duplex can abolish a false diagnosis of venous leakage in patients with impotence. The aim of this study is to identify any useful role of phentolamine redosing in diagnosis of venogenic impotence. Sixty-seven consecutive patients complaining of weak erection for at least 6 months were included in this study. Penile color Doppler ultrasound (CDU) was performed using a 7.5 MHz linear array transducer with a color flow mapping capability. Following intracavernous injection of 20 microg prostaglandin E1 (PGE1), all patients with persistent end diastolic velocity (EDV) >5 cm/sec with an erectile response of E3 or lower, 20 min after intracavernosal injection of PGE1, were asked to revisit our clinic for a second CDU, 2 weeks later. During initial CDU examination, all 67 patients experienced poor response to 20 microg PGE1 with their average peak systolic velocity (PSV) and EDV being 42.8 and 6.6 cm/sec, respectively. The second CDU examination had similar results to the first one. Addition of 2 mg phentolamine did not significantly change the PSV and EDV of cavernosal arteries in any of the 67 patients. In conclusion, addition of intracavernous phentolamine during PGE1 CDU examination carries no advantage over the use of PGE1 alone regarding cavernosal artery response in patients with suspected venogenic EDV.
    International Journal of Urology 05/2007; 14(5):476-7. · 1.73 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: This work is aimed at evaluating the effect of repeated intracavernosal injection (ICI) self-injection on the peak systolic velocity (PSV) and the diameter of cavernosal arteries. Sixty erectile dysfunction (ED) patients who were positive responders for ICI therapy were studied. Pharmacopenile duplex ultrasonography (PPDU) was carried out before starting ICI and after 10 doses of home therapy in an open-label uncontrolled study. There was significant increase in the cavernosal artery diameter and their PSV before and after injection. Cavernosal arteries diameter before injection in both right and left sides was 0.64+/-0.13 and 0.63+/-0.12 mm at the start and became 0.81+/-0.22 and 0.79+/-0.22 mm respectively at the end with significant differences (P<0.001). Cavernosal arteries diameter after injection in both right and left sides was 1.10+/-0.18 and 1.09+/-0.19 mm at the start and became 1.34+/-0.39 and 1.27+/-0.33 mm respectively at the end with significant differences (P<0.001). PSV at the start was 33.77+/-13.26 and 32.33+/-8.09 cm/s on both right and left sides and became 44.4+/-1.19 and 46.1+/-5.86 cm/s respectively at the end with significant differences (P<0.001). It is concluded that repeated ICI improves arterial erectile response with associated increase in PSV and cavernosal artery diameters.
    International Journal of Impotence Research 01/2007; 19(5):505-8. · 1.51 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: We attempted in this study to investigate the prevalence of Peyronie's disease (PD) among diabetic patients with erectile dysfunction (ED). Two-hundred and six diabetic patients were further evaluated in this study. Forty-two (20.3%) patients had PD. There were significant associations between PD and risk factors of age, obesity and smoking. All patients with PD had also ED. Penile curvature was present in 82.1% of all patients with PD. Of the patients with PD, 25.4% had pain with or without erection. Significant associations between PD and ED and ED duration were detected. This study confirmed the high prevalence of PD among diabetic patients with ED. Further work is needed probing the mechanisms through which diabetes affects the pathogenesis of ED and PD.
    International Journal of Impotence Research 01/2007; 19(2):213-7. · 1.51 Impact Factor
  • Source
    M Arafa, R Shamloul
    [Show abstract] [Hide abstract]
    ABSTRACT: Selective serotonin reuptake inhibitors (SSRIs) are increasingly used to treat premature ejaculation. We report a large prospective placebo-controlled crossover study of sertraline in premature ejaculation (PE) using Arabic Index of Premature Ejaculation (AIPE). One hundred and forty-seven men suffering from PE were enrolled in a randomized single-blinded crossover study of sertraline hydrochloride and placebo. Patients were randomized into group 1 (n=77) and group 2 (n=70). Both groups received sertraline and placebo interchangeably for 4 weeks. Overall, 127 (81%) of 157 subjects experienced a significant increase in their AIPE total score after sertraline treatment. Sixty-six (66%) of 100 patients available for follow-up experienced relapse of PE within 6 months after sertraline withdrawal. The active drug was generally well tolerated. Our relatively large study, using a validated questionnaire (AIPE), confirmed the useful effect of sertraline on PE.
    International Journal of Impotence Research 01/2006; 18(6):534-8. · 1.51 Impact Factor