scholarly journals Effects of testosterone treatment on clitoral haemodynamics in women with sexual dysfunction

2021 ◽  
Author(s):  
S. Cipriani ◽  
E. Maseroli ◽  
V. Di Stasi ◽  
I. Scavello ◽  
T. Todisco ◽  
...  
Keyword(s):  
Sexual Dysfunction ◽  
Sexual Function ◽  
Combined Therapy ◽  
Color Doppler ◽  
Density Lipoprotein ◽  
Peak Systolic Velocity ◽  
Color Doppler Ultrasound ◽  
Fasting Glycemia ◽  
Physical Laboratory ◽  
Registration Number

Abstract Purpose To explore the effects of 6-month systemic testosterone (T) administration on clitoral color Doppler ultrasound (CDU) parameters in women with female sexual dysfunction (FSD). Methods 81 women with FSD were retrospectively recruited. Data on CDU parameters at baseline and after 6 months with four different treatments were available and thus further longitudinally analyzed: local non-hormonal moisturizers (NH group), n = 37; transdermal 2% T gel 300 mcg/day (T group), n = 23; local estrogens (E group), n = 12; combined therapy (T + E group), n = 9. Patients underwent physical, laboratory, and genital CDU examinations at both visits and completed different validated questionnaires, including the Female Sexual Function Index (FSFI). Results At 6-month visit, T therapy significantly increased clitoral artery peak systolic velocity (PSV) when compared to both NH (p < 0.0001) and E (p < 0.0001) groups. A similar increase was found in the T + E group (p = 0.039 vs. E). In addition, T treatment was associated with significantly higher FSFI desire, pain, arousal, lubrication, orgasm, and total scores at 6-month visit vs. baseline. Similar findings were observed in the T + E group. No significant differences in the variations of total and high-density lipoprotein-cholesterol, triglycerides, fasting glycemia, insulin and glycated hemoglobin levels were found among the four groups. No adverse events were observed. Conclusion In women complaining for FSD, systemic T administration, either alone or combined with local estrogens, was associated with a positive effect on clitoral blood flow and a clinical improvement in sexual function, showing a good safety profile. Trial registration number NCT04336891; date of registration: April 7, 2020.

scholarly journals Significant relationship between parameters measured by transrectal color Doppler ultrasound and sexual dysfunction in patients with BPH 12 months after TURP

BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Li K. Chen ◽  
Yu W. Lai ◽  
Li P. Chiu ◽  
Saint Shiou-Sheng Chen
Keyword(s):  
Urinary Tract ◽  
Sexual Dysfunction ◽  
Lower Urinary Tract ◽  
Premature Ejaculation ◽  
Color Doppler ◽  
Color Doppler Ultrasound ◽  
Seminal Vesicles ◽  
Retrograde Ejaculation ◽  
Urinary Tract Symptoms ◽  
Lower Urinary

Abstract Background A link between sexual dysfunction and lower urinary tract symptoms due to benign prostatic hyperplasia (BPH) has been noticed. Transurethral resection of the prostate (TURP) remains the standard treatment for symptomatic BPH, whether TURP causes sexual dysfunction is still uncertain. In this retrospective study, we investigated the relationship between parameters measured by color Doppler ultrasound (CDU) and sexual dysfunction in patients with BPH 12 months after TURP. Methods The parameters include presumed circle area ratio (PCAR), maximal horizontal area of seminal vesicles (MHA), resistive index of the prostate (RIP), and peak systolic velocity in the flaccid penis (PSV). The international prostate symptom score was used to evaluate the lower urinary tract symptoms and the five-item version of the International Index of Erectile Function was used to evaluate sexual function before and after TURP. Results Of the 103 patients without sexual dysfunction before TURP, 11 (10.7%) had erectile dysfunction (ED) after TURP. These 11 patients had significantly lower PCAR, RIP, PSV and MHA than those without ED. The patients with retrograde ejaculation after TURP had significantly lower PCAR than those without retrograde ejaculation, and the patients with premature ejaculation after TURP had significantly lower MHA than those without premature ejaculation. Comparing the parameters between baseline and after TURP, PCAR, RIP, and MHA decreased significantly in the patients with sexual dysfunction, but no significant differences were noted in the patients without sexual dysfunction after TURP. Conclusions More extended TURP can lead to a higher incidence of ED and retrograde ejaculation in BPH patients without sexual dysfunction before TURP. Patients with a lower volume of seminal vesicles after TURP may have a higher incidence of premature ejaculation.

scholarly journals Frequency of Iatrogenic Sexual Dysfunction Associated with Antihypertensive Compounds

2021 ◽  
Vol 10 (22) ◽  
pp. 5214
Author(s):  
Bárbara Buch-Vicente ◽  
José Mª. Acosta ◽  
José-Angel Martín-Oterino ◽  
Nieves Prieto ◽  
María Elena Sánchez-Sánchez ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Calcium Antagonist ◽  
Sexual Dysfunction ◽  
Sexual Function ◽  
Antihypertensive Drugs ◽  
Combined Therapy ◽  
Real Life ◽  
Cross Sectional ◽  
Poor General Health

Iatrogenic sexual dysfunction (SD) caused by antihypertensive (AH) compounds, provoking sexual desire, orgasm or arousal dysfunction, is a common clinical adverse event. Unfortunately, it is often underestimated and underreported by clinicians and prescribers in clinical practice, deteriorating the adherence and patient quality of life. The objective of this study was to investigate the frequency of SD in patients treated with different antihypertensive compounds; a real-life naturalistic and cross-sectional study in patients receiving AH treatment was carried out. Method: A total of 256 patients were included in the study (188 males and 68 females who met the inclusion and exclusion criteria). The validated Psychotropic-Related Sexual Dysfunction Questionnaire (PRSexDQ-SALSEX) was transversally applied once at least every two months following the onset of the treatment in order to measure possible AH-related SD. Although the spontaneous reporting of SD was very low (6.81% females/24.8% males), 66.40% of the patients reported impaired sexual function through the SALSEX questionnaire after the treatment onset, as follows: decreased desire (55.8% females/54.2% males), delayed orgasm (42.6%/45.7%), anorgasmia (42.6%/43.6%) and arousal difficulties (53%/59.6%). The average frequency of moderate to severe iatrogenic SD was 66.4% with AH in monotherapy as follows: angiotensin II receptor antagonists (ARBs), 29.8%; calcium antagonists, 40%; diuretics, 42.9%; beta blockers, 43.8%; and angiotensin-converting enzyme (ACE) inhibitors, 77.8%. Combined treatments showed a higher percentage of main SD (70.3%): diuretic + ACE inhibitor, 42.3%; ARB + calcium antagonist, 55.6%; diuretic + calcium antagonist, 68.8%; and diuretic + ARB, 74.2%. The greatest risk factors associated with SD were poor general health, age over 60 with a comorbid coronary or musculoskeletal disease, mood disorder and diuretic +ARB combined therapy. Conclusion: SD is common in patients treated with antihypertensive drugs, and it is still underreported. The most harmful treatment deteriorating sexual function was the combination of diuretic +ARB, while the least harmful was monotherapy with ARBs. More research is needed on the clinical management of this problem to preserve the quality of life of patients and their partners.

scholarly journals Color Doppler ultrasound characteristics after subinguinal microscopic varicocelectomy

2017 ◽  
Vol 19 (1) ◽  
pp. 59 ◽  
Author(s):  
Murat Akand ◽  
Mustafa Koplay ◽  
Necat Islamoglu ◽  
Emre Altintas ◽  
Ozcan Kilic ◽  
...  
Keyword(s):  
Doppler Ultrasound ◽  
Color Doppler ◽  
Sperm Concentration ◽  
Peak Systolic Velocity ◽  
Resistive Index ◽  
Color Doppler Ultrasound ◽  
Semen Parameters ◽  
Pain Scores ◽  
Made In

Aim: The present study evaluated the effect of differences in the peak systolic velocity (PSV) and resistive index (RI) in the testicular artery (TA), capsular artery (CA), and intratesticular artery (ITA) after microscopic subinguinal varicocelectomy (MSV) on postoperative pain and semen parameters. Patients and Methods: Scrotal color Doppler ultrasound (CDUS) measurements were made in 33 patients (age 18-31 years) prior to MSV and 3 and 6 months after MSV. Pain was recorded using a visual analog scale and sperm concentration was determined to analyze the predictive value of the CDUS parameters regarding surgical outcome. Results: A significant decrease in pain scores was observed in most patients at both follow-ups. The first postoperative CDUS revealed a significant increase in the TA-PSV (p<0.001) and a decrease in the TA-RI (p=0.002) and CARI (p=0.006). The second postoperative CDUS also revealed a significant increase in the TA-PSV and a decrease in the TA-RI, and the PSV in the ITA and CA and RI in the ITA and CA were significantly different from the values obtained pre-operatively and at the first follow-up. A negative correlation was found between the pain level and TA-PSV (r=-0.433, p=0.012), whereas sperm concentration positively correlated with both the TA-PSV and CA-PSV (r=0.534, p=0.001 and r=0.455, p=0.008, respectively).Conclusions: The PSV and RI are useful parameters for detecting changes in testicular microhemodynamics after MSV. In addition, the TA-PSV and CA-PSV can be used to predict improvements in pain and sperm concentration.

scholarly journals Differences in Penile Hemodynamic Profiles in Patients with Erectile Dysfunction and Anxiety

2021 ◽  
Vol 10 (3) ◽  
pp. 402
Author(s):  
Rossella Cannarella ◽  
Aldo E. Calogero ◽  
Antonio Aversa ◽  
Rosita A. Condorelli ◽  
Sandro La Vignera
Keyword(s):  
Erectile Dysfunction ◽  
False Positive ◽  
Standard Dose ◽  
Color Doppler ◽  
Peak Systolic Velocity ◽  
Color Doppler Ultrasound ◽  
Hemodynamic Pattern ◽  
Diastolic Velocity ◽  
Severe Anxiety ◽  
Positive Results

Background: Penile echo-color Doppler ultrasound (PCDU) is the gold standard for the diagnosis of arterial erectile dysfunction (ED). Its reliability in patients with anxiety was questioned, due to false-positive results. Aim: To assess the penile hemodynamic response to intracavernous injection (ICI) of alprostadil in patients with anxiety-related ED. Methods: Patients with non-organic ED and a 5-item International Index of Erectile Function (IIEF-5) score ranging between 5 and 7 were enrolled. They were asked to compile the 7-item Generalized Anxiety Disorder (GAD-7) questionnaire to assess the degree of anxiety and were divided according to the GAD-7 score in Group 1 with minimal level of anxiety (n = 20), Group 2 with mild anxiety (n = 20), Group 3 with moderate anxiety (n = 20), and Group 4 with severe anxiety (n = 20). Peak systolic velocity (PSV) and the end-diastolic velocity (EDV) were sampled in all patients, through PCDU in the flaccid state, and 5, 10, 15, and 20 min after ICI of alprostadil at the standard dose of 10 μg. Results: In penile flaccidity, the patients showed a mean PSV of 8.0 ± 4.0 cm/s. The degree of anxiety was found to significantly influence both PSV and EDV at all assessed time-points. Particularly, it was negatively associated with the PSV at time 5 (r = −0.9, p < 0.01), 10 (r = −0.9, p < 0.01), 15 (r = −0.9, p < 0.01), and 20 (r = −0.7, p < 0.01) minutes, and positively with the EDV at time 5 (r = 0.7, p < 0.01), 10 (r = 0.6, p < 0.01), 15 (r = 0.5, p < 0.01), and 20 (r = 0.3, p < 0.01) minutes. Although all patients showed a mean dynamic PSV > 25 cm/s (which excluded an arterial ED according to the current guidelines), a peculiar hemodynamic pattern was found in patients with severe anxiety. In these patients, normal PSV values were reached only after 20 min from ICI, suggesting a “late-responder” profile. Conclusion: If further studies confirm the existence of a distinct hemodynamic profile in patients with severe anxiety, sampling the PSV and the EDV values could be proposed, for detecting patients with severe anxiety-related ED. Dynamic PCDU could be considered an accurate diagnostic test in patients with non-organic ED, since zero false-positive results were found in the present study. PSV in the flaccid state is not able to discriminate between arterial- or non-organic ED.

scholarly journals Vyrų sutrikusios lytinės funkcijos androgeniniai aspektai

2005 ◽  
Vol 3 (4) ◽  
pp. 0-0
Author(s):  
Antanas Balvočius
Keyword(s):  
Sexual Dysfunction ◽  
Sexual Function ◽  
Blood Serum ◽  
Medical Center ◽  
Combined Therapy ◽  
Combined Treatment ◽  
Digital Rectal Examination ◽  
Elderly Men ◽  
Androgen Therapy

Antanas BalvočiusTarptautinis medicinos centras Union Clinic Vilnius,Tilto g. 1/2, VilniusEl paštas: [email protected] Įvadas / tikslas Lytinių steroidinių hormonų endokrininiai sutrikimai neigiamai paveikia vyrų lytinę funkciją. Straipsnio tikslas – pateikti pagyvenusių vyrų lytinės disfunkcijos tyrimų ir gydymo rezultatus, apžvelgti mokslinę literatūrą apie endokrininę vyrų lytinės disfunkcijos patofiziologiją, diagnostiką ir gydymą. Ligoniai ir metodai Nuo lytinės disfunkcijos gydyti 64 pagyvenę (50–75 metų, vidutinis amžius 59 metai) vyrai. Erekcijos sutrikimai pagal TEFR-5 skalę svyravo nuo 11 iki 21 balo (vidutiniškai 15,5). Testosterono (T) kraujo serume buvo nuo 15,8 iki 4,6 nmol/L. Mažiau kaip 11 nmol/L rasta 44 vyrams (69%). Pavartoję FDE-5 inhibitorių, erekcijos kokybe buvo nepatenkinti iš 64 net 46 ligoniai, iš jų 35 ligoniams buvo taikytas kombinuotasis gydymas: 250 mg testosterono injekcijos į raumenis kas trys savaitės ir 5-fosfodiesterazės inhibitorius 1 valandą prieš lytinius santykius. Po 3 mėn. lytinės funkcijos pagal TEFR-5 skalę didesnis kaip 21 balas buvo 30 ligonių (85,7%). Rezultatai Hipogonadizmas yra klinikinis ir biocheminis sindromas, pasižymintis nepakankama androgenų koncentracija serume, dėl to gali sumažėti lytinė trauka, pablogėti erekcijos ir gyvenimo kokybė. Jei yra klinikinių indikacijų skirti androgenų terapiją, ja testosterono koncentracija turi būti palaikoma neviršijant fiziologinių ribų. Egzistuoja terapinis sinergizmas, kai esant hipogonadizmui taikomas kombinuotasis gydymas testosteronu ir 5-fosfodiesterazės inhibitoriais. Prieš terapiją ir reguliariai po jos būtina atlikti prostatos digitalinę rektalinę apžiūrą ir nustatyti prostatos specifinius antigenus kraujo serume. Androgenų terapija gali būti trumpalaikė arba ilgalaikė. Pastarajai reikia reguliariai ir dažnai stebėti pacientą, palankų bei šalutinį terapijos atsaką. Išvados Gydant pagyvenusių vyrų lytinę disfunkciją būtina atsižvelgti ir į steroidinių hormonų kiekį kraujo serume bei androgenų terapijos galimybes. Kombinuotąjį gydymą testosteronu ir 5-fosfodiesterazės inhibitoriais reikėtų skirti tiems erekcijos sutrikimų turintiems pacientams, kuriems nepakankamai padeda gydymas vien 5-fosfodiesterazės inhibitoriais. Reikšminiai žodžiai: lytinė disfunkcija; androgenai; andropauzė; testosteronas; prolaktinas dihidrotestosteronas, 5-fosfodiesterazės inhibitoriai, hormonų terapija Androgen aspects of male sexual dysfunction Antanas BalvočiusInternational Medical Center Union Clinic Vilnius,Tilto str. 1/2, Vilnius, LithuaniaE-mail: [email protected] Background / objective Steroid hormone endocrine disturbances have an adverse impact on sexual function in men. The aim of the article was to present findings of the study on sexual dysfunction in elderly men and results of their treatment together with a review of the literature on pathologic physiology, diagnostics and therapy of male endocrine sexual dysfunction. Patients and methods Sixty four elderly men (aged 50 to 75, mean age 59 years) were treated for sexual dysfunction. The score of erectile disturbances according to International Index of Erectile Function TEFR-5scale ranged from 11 to 21 (mean, 15.5). The blood testosterone (T) level was 15.8 to 4.6 nmol/l. The level lower than 11 nmol/l was found in 44 (69%) patients. Only 46 of 64 patients were not satisfied with the quality of erection after administration of PDE-5 inhibitors. A combined therapy was applied for 35 of 46 patients with a low T level: intramuscular T 250 mg injections three times a week and a FED-5 inhibitor one hour before sexual intercourse. Sexual function of >21 as assessed by TEFR-5 scale was determined for 30 (85.7%) patients after three months. Results Hypogonadism is a clinical and biochemical syndrome characterised by an insufficient serum androgen level, which may result in a decreased libido, lower quality of erection and decreased quality of life. If clinical indications for androgen therapy are present, it shall maintain the level of testosterone within the physiological limits. Therapeutic synergism is observed when a combined treatment including testosterone and phosphodiesterase-5 inhibitors is applied in hypogonadic men. Digital rectal examination of prostate and determination of values of blood serum prostate specific antigens are indispensable before the initiation of therapy and must be performed regularly afterwards. Androgen therapy may be short-term or long-term, and requires regular and frequent monitoring and observation for favourable and side response to the treatment. Conclusions The level of blood serum steroid hormones should be taken into account and the possibilities for androgen therapy considered in the therapy of sexual dysfunctions in elderly men. A combined treatment of erectile disorders with testosterone and phosphodiesterease-5 inhibitors should be administered to the patients in whom the treatment with phosphodiesterease-5 inhibitors alone is not helpful. Keywords: sexual dysfunction, androgens, andropause, testosterone, prolactin, dihydrotestosterone, phosphodiesterease-5 inhibitors, hormone therapy

Color Doppler Ultrasound Imaging in the Assessment of Iliac Endofibrosis

Angiology ◽  
2016 ◽  
Vol 68 (3) ◽  
pp. 225-232 ◽  
Author(s):  
Fabrizio D’Abate ◽  
Kosmas I. Paraskevas ◽  
Crispian Oates ◽  
Roger Palfreeman ◽  
Robert J. Hinchliffe
Keyword(s):  
Doppler Ultrasound ◽  
Color Doppler ◽  
Peak Systolic Velocity ◽  
Color Doppler Ultrasound ◽  
Iliac Arteries ◽  
Arterial Lumen ◽  
Doppler Ultrasound Imaging ◽  
Diastolic Velocity ◽  
Doppler Waveform ◽  
Limiting Condition

Endofibrosis (EF) of the iliac arteries is a flow-limiting condition typically seen in highly trained endurance athletes. Thirty-seven athletes (74 limbs) were referred to our department with suspected EF. All patients had a pre- and postexercise color Doppler ultrasound (CDU) of the iliac arteries. Doppler waveform and peak systolic velocity (PSV) and end-diastolic velocity (EDV) were assessed pre- and postexercise. Endofibrosis was diagnosed with CDU in 24 athletes (29 limbs). Arterial wall and course abnormalities were detected at rest in 20 (67%) symptomatic limbs of athletes with and 4 (22%) symptomatic limbs of athletes without EF. Postexercise abnormal waveforms of the stenotic/damped type were seen in the iliac arteries in all 29 limbs of athletes diagnosed with EF. These waveform changes were accompanied by high PSV (>350 cm/s) and EDV (>150 cm/s), with (n = 10; 34%) or without (n = 19; 66%) the evidence of reduced arterial lumen caliber. Color Doppler ultrasound can be used to detect EF.

Ventrolateral Preoptic Nucleus of Hypothalamus: A Possible Target for Deep Brain Stimulation for Treating Sexual Dysfunction

2020 ◽  
Vol 5 (3 And 4) ◽  
pp. 99-102
Author(s):  
Fariborz Ghaffarpasand ◽  
◽  
Mousa Taghipour ◽  
Keyword(s):  
Deep Brain Stimulation ◽  
Sexual Dysfunction ◽  
Sexual Function ◽  
Brain Stimulation ◽  
Sexual Behaviors ◽  
Angular Gyrus ◽  
Parahippocampal Gyrus ◽  
Left Caudate ◽  
Ventrolateral Preoptic Nucleus ◽  
Deep Brain

Sexual function and orientation is a complex platform of human personality which is being modulated by several brain circuities which is less understood currently. Recently, several studies have demonstrated interesting results regarding the role of several brain locations in sexual behaviors and orientation. Sexual arousal in homosexual men is associated with activation of the left angular gyrus, left caudate nucleus, Ventrolateral Preoptic (VLPO) Nucleus of Hypothalamus and right pallidum; while it is associated with bilateral lingual gyrus, right hippocampus, and right parahippocampal gyrus in heterosexual men. We postulate that sexual-orientation behaviors are being mediated by several circuits in the brain in the center of which the VLPO is playing an indistinguishable role. We hypothesize that the different aspects of the sexual dysfunction could be associated with innate or acquired lesions of VLPO. Accordingly, the electrical stimulation of the nucleus in those with sexual dysfunction would be a treatment option. Thus the VLPO could be considered a target for Deep Brain Stimulation (DBS) in individuals with impaired sexual function.

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