Rany Shamloul

The aim of the work is to evaluate the effect of repeated intracavernosal self-injection of vasoactive drugs in patients with elevated End Diastolic Velocity (>5 cm/sec) during pharmacopenile duplex ultrasonography (PPDU). Duplex evaluation was performed to the patients on self-injection therapy for comparison of end diastolic velocity and resistiv...

Erectile dysfunction is a common clinical entity that affects mainly men older than 40 years. In addition to the classical causes of erectile dysfunction, such as diabetes mellitus and hypertension, several common lifestyle factors, such as obesity, limited or an absence of physical exercise, and lower urinary tract symptoms, have been linked to th...

Cannabis (marijuana) is the most widely used illicit drug globally. Given the prevalence of nonprescription illicit drug abuse, there is a growing interest in the study of its potential effects on male sexual health. In this review, we discuss the effects of cannabis on male sexual health. In this review, we discuss the effects of cannabis on male...

The male genital system consists of both external and internal sexual and reproductive organs, including the penis as well as the testis, epididymis, vas deferens, seminal vesicle and the prostate. In this chapter, an overview of the gross and microscopic anatomy of the male genitalia is provided. KeywordsAnatomy-Prostate-Arterial supply-Cavernous...

Introduction. Genital morphology (especially male) among the animal kingdom is characterized by extensive differences that even members of closely related species with similar general morphology may have remarkably diverse genitalia. Aim. To present the sexual medicine specialist with a basic understanding of the current hypotheses on genital evolu...

Priapism describes a persistent erection arising from dysfunction of mechanisms regulating penile tumescence, rigidity, and flaccidity. A correct diagnosis of priapism is a matter of urgency requiring identification of underlying hemodynamics. To define the types of priapism, address its pathogenesis and epidemiology, and develop an evidence-based...

The search for a remedy or a prescription that can enhance sexual function and/or treat male erectile dysfunction has been an obsession throughout known history. Whether it was an Eastern civilization or a Western one, religious or atheist, man's aspiration for a better or best "manhood" has been a history-time goal. This review will discuss the cu...

Recently there has been a growing interest regarding the role of carbon monoxide (CO) and its precursor, heme oxygenase (HO) in mediation of penile erection and their potential roles as molecular targets in treatment of erectile dysfunction. To review the available literature on the role of the HO/CO system in male sexual dysfunctions. This review...

Evidence-based medicine (EBM) is the integration of best research evidence with clinical expertise and patient preferences and values. Aim: This narrative review aims to assist the physicians to make informed decisions based on the best available evidence in the area of male infertility and the patients' own preferences and values. In this review w...

Despite the major breakthroughs basic research in erectile physiology experienced in the last, most of the methods used for quantitative assessment of erectile function in longitudinal studies suffer many drawbacks. This review will focus on radiotelemetric assessment of intracavernosal (ICP) and intraspongiosal (ISP) regarding the technique, data...

Currently there is no universally accepted gold standard diagnostic test to differentiate psychogenic from physical erectile dysfunction (ED). Instead, sexual health specialists rely on a detailed history, a focused physical examination, and specialized diagnostic tests, to decide if the etiology of the ED is mainly psychogenic or organically cause...

Sildenafil has been used successfully in the treatment of honeymoon impotence. However, no study investigated the potential effect of tadalafil in the treatment of honeymoon impotence. The aim of this study is to evaluate the effectiveness of alternate-day tadalafil therapy in the management of unconsummated marriages. This is a descriptive study c...

Treatments of aged, male hypertensive rats that induce vascular remodeling or that normalize endothelial function are known to produce sustained improvements in erectile function. Whether the treatments targeting these processes benefit female genital vasocongestive arousal (GVA) responses is currently not known. To determine whether the actions of...

Objectives To examine whether the actions of nitric oxide (NO) were critical to the apomorphine-generated genital vasocongestive arousal (GVA) responses in both intact and ovariectomized (OVX) young adult female rats. We also investigated whether the diminished GVA responses in aged rats could be restored using an antihypertensive treatment. Design...

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 b...

Penile augmentation surgery has become increasingly common though there is no consensus about the management strategy for men with a complaint of small penis. To introduce and evaluate the outcome of a structured management and counseling protocol for patients with a complaint of a small-sized penis. A structured protocol for consultation and manag...

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 ra...

We report a new technique of preserving the lymphatics during varicocelectomy using saline infusion that we have termed "lymphatic hydrodissection."

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...

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 w...

The main advantages of semirigid penile prosthesis are simple implantation, ease of use, very low risk of mechanical failure and more financial suitability for patients in developing countries. To evaluate reliability and safety of Tube(R) (Promedon, Cordoba, Argentina) penile prosthesis in the surgical treatment of erectile dysfunction. This retro...

Treatment of established hypertension, especially for prolonged control of this pathogenic process, represents a great challenge. To upregulate the expression of heme oxygenase (HO) to lower blood pressure (BP) of spontaneously hypertensive rats (SHRs), we administered hemin to 12-week-old adult SHRs through subcutaneously implanted osmotic minipum...

Erectile dysfunction (ED) is increased in prevalence in patients with arterial hypertension. Whether upregulation of heme oxygenase (HO) expression could improve penile erection has been unknown. To correlate altered expression profiles of HO-1 and soluble guanylyl cyclase (sGC) in penile tissues with low intracavernosal pressure (ICP) in adult spo...

Penile reconstructive surgeries are performed mainly as radical treatment for conditions associated with congenital abnormalities of the urethra or penis, after penile trauma, penile cancer, short penis, corporal fibrosis and in cases of gender reassignment. In this article, we review the controversial penile augmentation topic, clarifying how most...

To evaluate the efficacy of regular prostatic massage in combination with culture-specific antibiotic therapy for men with chronic prostatitis. This study included 81 consecutive patients who attended our outpatient clinic with a history or symptoms suggestive of chronic prostatitis (National Institutes of Health category II and IIIA). In addition...

To evaluate the incidence of erectile dysfunction (ED), its severity, and other sexual function domains in 800 Egyptian patients with hypertension. All patients completed a detailed questionnaire addressing their general medical history, with special emphasis on hypertension (ie, duration of hypertension, type of antihypertensive treatment, complia...

Introduction. Premature ejaculation (PE) is regarded as the most common male sexual disorder. Previous studies reported that prostatic inflammation was highly prevalent in PE. However, the effect of antibiotic treatment of cases with PE and chronic prostatitis has not been extensively investigated. Aim. To examine the effect of antibiotic treatment...

In order to accurately assess the extent of chronic pelvic pain syndrome (CPPS) and to objectively measure symptoms for natural history studies and to assess the outcome parameters for clinical trials, the National Institutes of Health (NIH) Chronic Prostatitis Collaborative Research Network developed and validated the NIH Chronic Prostatitis Sympt...

Introduction of duplex ultrasonography with color flow Doppler analysis after intracavernous injection of vasoactive drugs has been reported to be a minimally invasive and accurate method, and considered the gold-standard technique for evaluating penile hemodynamics. However, several studies have demonstrated that in some cases Color Doppler Ultras...

Introduction: Premature ejaculation is a common male sexual dysfunction, affecting 30-40% of sexually active men in an age-dependent manner. Chronic prostatitis has been suggested as an important organic cause of premature ejaculation. Aim: The aim of this study was to confirm previous data reported on the incidence of chronic prostatitis in a l...

To determine the value of penile duplex ultrasonography in predicting the occurrence of intracavernous drug-induced ischemic priapism directly after the rigid erection phase. We evaluated 250 men with erectile dysfunction by color Doppler ultrasonography after the diagnostic injection of papaverine hydrochloride and phentolamine mesylate. Cavernosa...

Introduction. Erectile dysfunction (ED) and depression are highly prevalent medical disorders affecting men of diverse cultures throughout the world. Tianeptine is a new antidepressant drug with less adverse effects on sexual functions. Aim. To evaluate the efficacy of tianeptine in the treatment of mild to moderate depression with ED. Methods and...

Introduction. Chronic priapism represents a challenging therapeutic dilemma. Inadequate or deferred treatment can result in impaired quality of life and permanent erectile dysfunction. The etiology of stuttering priapism is speculated to be initially an ischemic injury that damages the neurologic and/or endothelial-mediated mechanisms that normally...

Recent studies suggest a direct relationship between free testosterone and cavernous vasodilatation. Some men with erectile dysfunction (ED) associated with PADAM (partial androgen deficiency in aging men) might possibly benefit from testosterone undecanoate therapy (TRT). To determine the efficacy of testosterone undecanoate in facilitating the er...

Introduction. Some of the more common complications of intracavernous injection (ICI) therapy include pain and prolonged erections. Rare reported complications include intracorporeal needle breakage and postinjection cavernositis. Aim. We report a case of early management of postinjection cavernositis resulting in preservation of erectile function...

To report the outcome of a sex education-integrated treatment program of men complaining of a short-sized penis. This study included 92 patients presenting to our department in the past 2 years complaining of a small-sized penis. History, with particular stress on the duration of the complaint and sexual habits of the patients, was collected from a...

Introduction. Honeymoon impotence can be defined as the failure to be successfully involved in sexual intercourse at the beginning of marriage, particularly in the first few nights. While its exact causes are not yet elucidated, many studies recognize this problem as related to performance anxiety. Aim. The aim of this study was to report the outco...

To evaluate the efficacy of topical application of viable bacille Calmette-Guérin (BCG) as a primary line of treatment in patients with condylomata acuminata. We recruited 50 patients from the Department of Andrology and Sexually Transmitted Diseases, Cairo University Hospital complaining of genital warts. Patients were divided into two groups. Gro...

The aim of our work is to evaluate the efficacy of intracavernous sodium nitroprusside (SNP) in management of erectile dysfunction (ED) in a clinical comparative study with papaverine/phentolamine in ED patients. The study included 40 patients with ED divided into two groups. Group I include 20 patients receiving intracavernous (30 mg papaverine +...

Common complications of intracavernous injection therapy include pain, hematoma formation, syncope, prolonged erections, and penile fibrosis. Rare reported complications include postinjection cavernositis, intracorporeal needle breakage. We report a case of postinjection intracavernous needle breakage with successful ultrasound-guided retrieval. A...

Intracavernous pharmacotherapy is one of the most common treatment modalities of erectile dysfunction (ED). There are different drugs that are used for intracavernous injection including papaverine, phentolamine, prostaglandins E1, phenoxybenzamine, and moxisylate. The aim of this study is to evaluate the efficacy of chlorpromazine as an intracaver...

Testicular needle aspiration has been proposed as a simple alternative to open biopsy for the diagnosis and treatment of azoospermia. This study describes a new modification of needle aspiration biopsy using an ordinary intravenous catheter to retrieve testicular spermatozoa from patients with obstructive azoospermia, and compares it to the classic...