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Oral therapy for erectile dysfunction: An overview  [cached]
Soni M,Patidar K,Sharma D,Soni P
Asian Journal of Pharmaceutics , 2009,
Abstract: Over the past 20 years, treat ment options for erectile dysfunction (ED) have become more effective and, despite the effectiveness of intracavernous injections, vacuum devices, surgery and other treatments, there has been a trend toward the development of less-invasive modalities. Oral drugs have become the first-line therapeutic option for many men with ED. This review highlights the pathophysiology of ED, oral therapy for ED and new drug targets for the treatment of ED products available in the market for ED.
Diagnosis and Therapy of Erectile Dysfunction in Man
Ekmek?io?lu, O.,Demirta?, A.
Erciyes Medical Journal , 2006,
Abstract: The prevalence of erectile dysfunction (ED) increases with age. There are several options in the diagnosis and treatment of the patients. Some patients with occult cardiovascular diseases might appear with only the complaint of ED. The patients are reluctant to tell their sexual problems. The purpose of healthcare providers should be to find out and direct the patients with ED which is an issue capable of decreasing quality of life. The treatment has become easier with the widespread use of some new oral medications. These drugs are phosphodiesterase type V enzyme inhibitors and have decreased the use of other more invasive treatment options. Optimal treatment of the patients might increase the quality of life of both the male and his partner. In this review, the options in the diagnosis and treatment of ED are discussed.
Advances in stem cell therapy for the lower urinary tract  [cached]
Ching-Shwun Lin
World Journal of Stem Cells , 2010,
Abstract: Lower urinary tract diseases are emotionally and financially burdensome to the individual and society. Current treatments are ineffective or symptomatic. Conversely, stem cells (SCs) are regenerative and may offer long-term solutions. Among the different types of SCs, bone marrow SCs (BMSCs) and skeletal muscle-derived SCs (SkMSCs) have received the most attention in pre-clinical and clinical trial studies concerning the lower urinary tract. In particular, clinical trials with SkMSCs for stress urinary incontinence have demonstrated impressive efficacy. However, both SkMSCs and BMSCs are difficult to obtain in quantity and therefore neither is optimal for the eventual implementation of SC therapy. On the other hand, adipose tissue-derived SCs (ADSCs) can be easily and abundantly obtained from “discarded” adipose tissue. Moreover, in several head-on comparison studies, ADSCs have demonstrated equal or superior therapeutic potential compared to BMSCs. Therefore, across several different medical disciplines, including urology, ADSC research is gaining wide attention. For the regeneration of bladder tissues, possible differentiation of ADSCs into bladder smooth muscle and epithelial cells has been demonstrated. For the treatment of bladder diseases, specifically hyperlipidemia and associated overactive bladder, ADSCs have also demonstrated efficacy. For the treatment of urethral sphincter dysfunction associated with birth trauma and hormonal deficiency, ADSC therapy was also beneficial. Finally, ADSCs were able to restore erectile function in various types of erectile dysfunction (ED), including those associated with diabetes, hyperlipidemia, and nerve injuries. Thus, ADSCs have demonstrated remarkable therapeutic potentials for the lower urinary tract.
Human Urine-Derived Stem Cells Alone or Genetically-Modified with FGF2 Improve Type 2 Diabetic Erectile Dysfunction in a Rat Model  [PDF]
Bin Ouyang, Xiangzhou Sun, Dayu Han, Shenfu Chen, Bing Yao, Yong Gao, Jun Bian, Yanping Huang, Yadong Zhang, Zi Wan, Bin Yang, Haipeng Xiao, Zhou Songyang, Guihua Liu, Yuanyuan Zhang, Chunhua Deng
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0092825
Abstract: Aim The aim of this study was to determine the possibility of improving erectile dysfunction using cell therapy with either human urine-derived stem cells (USCs) or USCs genetically-modified with FGF2 in a type 2 diabetic rat model. Methods Human USCs were collected from 3 healthy donors. USCs were transfected with FGF2 (USCs-FGF2). Sixty-five SD male rats were divided into five groups (G). A control group of normal rats (G1, n = 10), and four other test groups of type 2 diabetic erectile dysfunction rats: PBS as a negative control (G2, n = 10), USCs (G3, n = 15), lentivirus-FGF2 (G4, n = 15), and USCs-FGF2 (G5, n = 15). Diabetes was induced in the rats via a high fat diet for 28 days and a subsequent intraperitoneal injection of streptozotocin (35 mg/kg). Erectile dysfunction was screened with apomorphine (100 μg/kg). Cell injections in the test groups (G2–G5) occurred directly into the corpora cavernosa. The implanted cells were tracked at 7 days (n = 5 animals/G) and 28 days (n = 10 animals/G) post injection. Mean arterial pressure (MAP), intracavernosal pressure (ICP), expression of endothelial markers (CD31, VEGF and eNOS), smooth muscle markers (desmin and smoothelin), histological changes and erectile function were assessed for each group. Results USCs expressed mesenchymal stem cell markers, and secreted a number of proangiogenic growth factors. USCs expressed endothelial cell markers (CD31 and vWF) after transfection with FGF2. Implanted USCs or USCs-FGF2 displayed a significantly raised ICP and ICP/MAP ratio (p<0.01) 28 days after intracavernous injection. Although few cell were detected within the implanted sites, histological and western blot analysis demonstrated an increased expression of endothelial and smooth muscle markers within the cavernous tissue following USC or USC-FGF2 injection. Conclusions The paracrine effect of USCs or USCs-FGF2 induced improvement of erectile function in type 2 diabetic rats by recruiting resident cells and increasing the endothelial expression and contents of smooth muscle.
The erectile dysfunction
Johan Eduardo Ardila Jaimes
MedUNAB , 2002,
Abstract: The erectile dysfunction (ED) is a high prevalence disorderassociated to psychological and mainly organic factors thatcan affect at men of any age. The increase of the knowledgeof the physiologic mechanisms of the masculine erection andthe development of new agents that improve the erectilefunction have generated great interest among the physicians,the men and their couples because these advances areextending the available options in the management of thisdisorder. In this article we revise the etiologic andphysiopathologic aspects, as well as the clinical focus andthe current management of the ED.
Hydrogen therapy may be a promising, safe and effective treatment for diabetic erectile dysfunction: a hypothesis  [cached]
Jun Chen,Bin Zhang,Mingchao Li,Tao Qi
Alternative Medicine Studies , 2011, DOI: 10.4081/ams.2011.e11
Abstract: Inhalation of hydrogen gas has been proven to be an effective treatment for ischemiareperfusion injury by selectively reducing hydroxyl and peroxynitrite radicals. There has been considerable evidence of hydrogen’s protective effect against diseases related to oxidative injury, such as the ischemia-reperfusion injury of the brain, liver and heart. More and more studies suggest that radical oxygen species (ROS) play an important role in the development of diabetic erectile dysfunction (ED) and antioxidants can markedly decrease the production of ROS and improve the erectile function. We hypothesize that hydrogen therapy may be a promising, safe and effective treatment for diabetic ED by reducing the production of ROS.
Patient preference and satisfaction in erectile dysfunction therapy: a comparison of the three phosphodiesterase-5 inhibitors sildenafil, vardenafil and tadalafil
Amr Abdel Raheem, Philip Kell
Patient Preference and Adherence , 2009, DOI: http://dx.doi.org/10.2147/PPA.S3349
Abstract: tient preference and satisfaction in erectile dysfunction therapy: a comparison of the three phosphodiesterase-5 inhibitors sildenafil, vardenafil and tadalafil Review (5480) Total Article Views Authors: Amr Abdel Raheem, Philip Kell Published Date April 2009 Volume 2009:3 Pages 99 - 104 DOI: http://dx.doi.org/10.2147/PPA.S3349 Amr Abdel Raheem1, Philip Kell2 1St. Peter’s Andrology Department, The Institute of Urology, London, and Cairo University, Egypt; 2St. Peter’s Andrology Department, The Institute of Urology, London, UK Abstract: Erectile dysfunction (ED) is a problem that may affect up to 52% of men between the ages of 40 and 70. It can be distressing because of its negative effect on self-esteem, quality of life, and interpersonal relationships. Oral phosphodiesterase-5 inhibitors (PDE5 inhibitors) are now the first choice of treatment in ED. The availability of three (sildenafil citrate, tadalafil, and vardenafil) well tolerated and effective oral PDE5 inhibitors gives treatment options for men with ED. Although the mechanism of action is the same for the three drugs, they differ in their pharmacokinetics. Several preference studies were conducted between the three PDE5 inhibitors but they were not free from bias. Because of the lack of overwhelming reliable data showing that one PDE5 inhibitor is superior to another, current opinion is that the individual patient should have the opportunity to test all three drugs and then select the one that best suits him and his partner.
Erectile dysfunction following intravitreal bevacizumab  [cached]
Yohendran Jayshan,Chauhan Devinder
Middle East African Journal of Ophthalmology , 2010,
Abstract: Despite initial concerns regarding systemic complications, the use of intravitreal antivascular endothelial growth factor (anti-VEGF) agents for ocular disease is rapidly expanding worldwide, in terms of both the number of patients injected and its indications. To our knowledge, there are no cases in the literature reporting erectile dysfunction following the use of intravitreal bevacizumab. We postulate an organic mechanism for impaired erectile function due to systemically absorbed intravitreal bevacizumab. We describe a case of erectile dysfunction following intravitreal bevacizumab administration. Color fundus photos, fluorescein angiogram and optical coherence tomography images are presented. A 40-year-old male underwent intravitreal bevacizumab therapy for macular edema secondary to a branch retinal vein occlusion. He subsequently developed transient erectile dysfunction after each of his two bevacizumab injections. His only comorbidity was mild hypertension. Erectile dysfunction may be a side effect of intravitreal bevacizumab. The erectile dysfunction could be organic and/or psychogenic in etiology.
Correction of Diabetic Erectile Dysfunction with Adipose Derived Stem Cells Modified with the Vascular Endothelial Growth Factor Gene in a Rodent Diabetic Model  [PDF]
Guihua Liu, Xiangzhou Sun, Jun Bian, Rongpei Wu, Xuan Guan, Bin Ouyang, Yanping Huang, Haipeng Xiao, Daosheng Luo, Anthony Atala, Yuanyuan Zhang, Chunhua Deng
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0072790
Abstract: The aim of this study was to determine whether adipose derived stem cells (ADSCs) expressing vascular endothelial growth factor (VEGF) gene can improve endothelial function, recover the impaired VEGF signaling pathway and enhance smooth muscle contents in a rat diabetic erectile dysfunction (DED) model. DED rats were induced via intraperitoneal injection of streptozotocin (40 mg/kg), and then screened by apomorphine (100 μg/kg). Five groups were used (n = 12/group)–Group 1 (G1): intracavernous injection of lentivirus-VEGF; G2: ADSCs injection; G3: VEGF-expressing ADSCs injection; G4: Phosphate buffered saline injection; G1–G4 were DED rats; G5: normal rats. The mean arterial pressure (MAP) and intracavernosal pressure (ICP) were measured at days 7 and 28 after the injections. The components of the VEGF system, endothelial, smooth muscle, pericytes markers in cavernoursal tissue were assessed. On day 28 after injection, the group with intracavernosum injection of ADSCs expressing VEGF displayed more efficiently and significantly raised ICP and ICP/MAP (p<0.01) than those with ADSCs or lentivirus-VEGF injection. Western blot and immunofluorescent analysis demonstrated that improved erectile function by ADSCs-VEGF was associated with increased expression of endothelial markers (VEGF, VEGF R1, VEGF R2, eNOS, CD31 and vWF), smooth muscle markers (a-actin and smoothelin), and pericyte markers (CD146 and NG2). ADSCs expressing VEGF produced a therapeutic effect and restored erectile function in diabetic rats by enhancing VEGF-stimulated endothelial function and increasing the contents of smooth muscle and pericytes.
Preclinical Evidence for the Benefits of Penile Rehabilitation Therapy following Nerve-Sparing Radical Prostatectomy  [PDF]
M. Albersen,S. Joniau,H. Claes,H. Van Poppel
Advances in Urology , 2008, DOI: 10.1155/2008/594868
Abstract: Erectile dysfunction following radical prostatectomy remains a frequent problem despite the development of nerve-sparing techniques. This erectile dysfunction is believed to be neurogenic, enhanced by hypoxia-induced structural changes which result in additional veno-occlusive dysfunction. Recently, daily use of intracavernous vasoactive substances and oral use of PDE5-inhibitors have been clinically studied for treatment of postprostatectomy erectile dysfunction. Since these studies showed benefits of “penile rehabilitation therapy,” these effects have been studied in a preclinical setting. We reviewed experimental literature on erectile tissue preserving and neuroregenerative treatment strategies, and found that preservation of the erectile tissue by the use of intracavernous nitric oxide donors or vasoactive substances, oral PDE5-inhibitors, and hyperbaric oxygen therapy improved erectile function by antifibrotic effects and preservation of smooth muscle. Furthermore, neuroregenerative strategies using neuroimmunophilin ligands, neurotrophins, growth factors, and stem cell therapy show improved erectile function by preservation of NOS-containing nerve fibers.
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