scholarly journals Penile Artery 18F-NaF Uptake and Erectile Dysfunction

2019 ◽  
Vol 73 (12) ◽  
pp. 1395-1397
Author(s):  
Ahmed Tawakol ◽  
Michael T. Osborne ◽  
Francis J. McGovern
Keyword(s):  
Erectile Dysfunction ◽  
Penile Artery

Erectile dysfunction as a marker and predictor of cardiovascular disease

2018 ◽  
Author(s):  
Charalambos Vlachopoulos ◽  
Nikolaos Ioakeimidis
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Erectile Dysfunction ◽  
Cardiovascular Risk ◽  
Endothelial Dysfunction ◽  
Coronary Circulation ◽  
Atherosclerotic Burden ◽  
Penile Artery ◽  
Coronary Events ◽  
Artery Disease

Erectile dysfunction (ED) is defined as the inability to obtain or maintain a penile erection to support satisfactory sexual performance. It is considered an early manifestation of generalized vascular disease and recognized as a marker of increased cardiovascular risk both acutely and chronically by predicting all-cause mortality, cardiovascular mortality, coronary events, stroke, and peripheral artery disease in men with and without known coronary artery disease. The link between ED and cardiovascular disease might reside in the interaction between androgen level, chronic inflammation, and cardiovascular risk factors that determine endothelial dysfunction and atherosclerosis both in the penile and coronary circulation. Because penile artery size is smaller compared with coronary arteries, the same degree of endothelial dysfunction and atherosclerotic burden causes a more significant reduction of blood flow in erectile tissues compared with that in coronary circulation. From a clinical standpoint, because ED may precede cardiovascular disease, it can be used as an early marker to identify men at higher risk of cardiovascular events. The average 3-year time period between the onset of ED symptoms and a cardiovascular event offers the opportunity for detailed cardiological assessment and intensive treatment of risk factors.

Safety and six-month durability of angioplasty for isolated penile artery stenoses in patients with erectile dysfunction: a first-in-man study

2014 ◽  
Vol 10 (1) ◽  
pp. 147-156 ◽  
Author(s):  
Tzung-Dau Wang ◽  
Wen-Jeng Lee ◽  
Shao-Chi Yang ◽  
Po-Chih Lin ◽  
Huai-Ching Tai ◽  
...  
Keyword(s):  
Erectile Dysfunction ◽  
Penile Artery

Erectile dysfunction as a marker and predictor of cardiovascular disease

ESC CardioMed ◽  
2018 ◽  
pp. 1016-1019
Author(s):  
Charalambos Vlachopoulos ◽  
Nikolaos Ioakeimidis
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Erectile Dysfunction ◽  
Cardiovascular Risk ◽  
Endothelial Dysfunction ◽  
Coronary Circulation ◽  
Atherosclerotic Burden ◽  
Penile Artery ◽  
Coronary Events ◽  
Artery Disease

Erectile dysfunction (ED) is defined as the inability to obtain or maintain a penile erection to support satisfactory sexual performance. It is considered an early manifestation of generalized vascular disease and recognized as a marker of increased cardiovascular risk both acutely and chronically by predicting all-cause mortality, cardiovascular mortality, coronary events, stroke, and peripheral artery disease in men with and without known coronary artery disease. The link between ED and cardiovascular disease might reside in the interaction between androgen level, chronic inflammation, and cardiovascular risk factors that determine endothelial dysfunction and atherosclerosis both in the penile and coronary circulation. Because penile artery size is smaller compared with coronary arteries, the same degree of endothelial dysfunction and atherosclerotic burden causes a more significant reduction of blood flow in erectile tissues compared with that in coronary circulation. From a clinical standpoint, because ED may precede cardiovascular disease, it can be used as an early marker to identify men at higher risk of cardiovascular events. The average 3-year time period between the onset of ED symptoms and a cardiovascular event offers the opportunity for detailed cardiological assessment and intensive treatment of risk factors.

The Implications of Increasing Age on Erectile Dysfunction

2012 ◽  
Vol 6 (4) ◽  
pp. 273-279 ◽  
Author(s):  
Kamal C. Wagle ◽  
Maurita H. Carrejo ◽  
Robert S. Tan
Keyword(s):  
Erectile Dysfunction ◽  
Well Being ◽  
Older Men ◽  
Age Group ◽  
Self Administration ◽  
Waiting Room ◽  
Penile Artery ◽  
Younger Men ◽  
History Of

Erectile dysfunction (ED) has long been correlated with psychological well-being. More recently, an understanding has developed of ED being, in some cases, a vascular condition of the penile artery. Given the narrowness of the penile artery, a small amount of atherosclerosis may result in ED before any other manifestations are evident, making ED a useful marker for other vascular conditions with potentially greater clinical implications. In light of this, possible underreporting of ED takes on added significance. A questionnaire regarding ED prevalence and management was distributed for self-administration to men in the waiting room of primary care clinics; the data were analyzed with a focus on the relationship between ED and age. The study had a remarkable response rate of >95%. The prevalence of ED in the ≥70-year age-group was 77%, compared with 61% in the 40- to 69-year age-group ( p = .0001). ED correlated linearly with age ( R2 = .80, p < .0001). Among those who had ED, more than half had not discussed it with any provider; the likelihood of discussing ED did increase with the reported severity of symptoms ( p < .0001). Older men had more severe ED than younger men ( p < .0001). Furthermore, 72% of men with a history of ED were never treated. Younger men were more likely to be treated than older men ( p = .004). Given the potential implications of underreporting ED, and the willingness of the men in this study to complete the questionnaire, further work may be merited on new models for ED assessment and follow-up.

Clinical and Imaging Outcomes up to 1 Year Following Balloon Angioplasty for Isolated Penile Artery Stenoses in Patients With Erectile Dysfunction

2016 ◽  
Vol 23 (6) ◽  
pp. 867-877 ◽  
Author(s):  
Tzung-Dau Wang ◽  
Wen-Jeng Lee ◽  
Shao-Chi Yang ◽  
Po-Chih Lin ◽  
Huai-Ching Tai ◽  
...  
Keyword(s):  
Erectile Dysfunction ◽  
Balloon Angioplasty ◽  
Clinical Success ◽  
Unmet Need ◽  
Secondary Outcome ◽  
Lesion Length ◽  
Secondary Outcome Measure ◽  
Binary Restenosis ◽  
Penile Artery ◽  
The Mean

Purpose: To assess the angiographic and clinical outcomes in patients with erectile dysfunction and isolated penile artery stenoses treated by balloon angioplasty. Methods: In this prospective study, 22 patients (mean age 61.0±7.6 years, range 50–79) with erectile dysfunction and 34 isolated penile artery stenoses (mean 74.9%±9.1%) were enrolled and underwent balloon angioplasty. The mean International Index for Erectile Function–5 (IIEF-5) score at baseline was 10.3±4.5. The mean lesion length was 11.1±9.0 mm (mean reference vessel diameter 1.7±0.4 mm). The primary endpoint was in-segment restenosis ≥50% by pelvic computed tomography angiography (CTA) at 8 months. The 1-year sustained clinical success (IIEF-5 score ≥22 or a ≥4-point change in the IIEF-5 score and no later decline by ≥4) was the secondary outcome measure. Results: Procedural success was achieved in 31 (91%) of 34 stenotic lesions; there was 1 flow-limiting dissection and 2 arteries with >30% residual stenosis. At 8 months, 14 of 34 lesions in 13 of 22 patients had CTA-documented binary restenosis. At 1 year, sustained clinical success was achieved in 11 of 22 patients. Of the 9 patients not developing binary restenosis, 8 achieved sustained clinical success. Conclusion: Our findings establish the safety and efficacy of penile artery angioplasty for patients with erectile dysfunction and isolated penile artery stenoses. They also highlight the unmet need for a more enduring treatment strategy for penile artery stenotic disease.

scholarly journals Early Recoil After Balloon Angioplasty of Erection-Related Arteries in Patients With Arteriogenic Erectile Dysfunction

2018 ◽  
Vol 25 (6) ◽  
pp. 710-715 ◽  
Author(s):  
Nicolas Diehm ◽  
Dai-Do Do ◽  
Hak-Hong Keo ◽  
Jana Boerlin ◽  
Christian Regli ◽  
...  
Keyword(s):  
Erectile Dysfunction ◽  
Balloon Angioplasty ◽  
Erectile Function ◽  
Balloon Dilation ◽  
Clinical Results ◽  
Lesion Length ◽  
Consecutive Series ◽  
Elastic Recoil ◽  
Endovascular Revascularization ◽  
Penile Artery

Purpose: To evaluate the incidence of elastic recoil in patients presenting with erectile dysfunction (ED) undergoing endovascular revascularization of the pudendal or penile arteries. Methods: A consecutive series of 21 ED patients (mean age 58.3±9.3 years) undergoing minimally invasive revascularization of 31 arteries was analyzed. ED lesions included the pudendal arteries (n=27) and the penile artery (n=4). Mean lesion length was 20.6±13.9 mm. Minimal lumen diameter (MLD) measurements were assessed at baseline, immediately after balloon angioplasty, and 10 minutes thereafter. Early recoil was defined as an MLD reduction >10%. Elastic recoil with >10% lumen compromise was treated with drug-coated balloons, while severe elastic recoil (>30%) required drug-eluting stents (DES). The International Index of Erectile Function (IIEF-15) score was obtained prior to and 3 months after the procedure to obtain information on functional outcomes subsequent to angioplasty. Results: Mean MLD at baseline was 0.9±0.6 mm, which improved to 2.0±0.9 mm immediately after balloon dilation. At 10 minutes after dilation, the MLD was 1.7±1.0 mm. Elastic recoil was observed in all 31 lesions and resulted in a mean lumen compromise of 21.2%. Severe (>30%) recoil was observed in 14 arteries, which underwent DES therapy. The IIEF-15 score improved from 31.3±11.2 at baseline to 49.8±16.8 (p<0.001) at the 3-month follow-up. Conclusion: Endovascular revascularization constitutes a safe and feasible treatment modality to restore erectile function in patients with arteriogenic ED and ineffective conservative management. Early elastic recoil is very frequent subsequent to balloon dilation of small-caliber erection-related arteries. Thus, mechanical scaffolding with DES is required in a high subset of ED patients to provide favorable early angiographic and clinical results.

Frequency and anatomic distribution of arterial obstructions in patients with vasculogenic erectile dysfunction not responding to intracavernous prostaglandin

VASA ◽  
2021 ◽  
pp. 1-6
Author(s):  
Vignes Mohan ◽  
Giuseppe Sangiorgi ◽  
Jonas Knöchel ◽  
Hak-Hong Keo ◽  
Jan Schönhofen ◽  
...  
Keyword(s):  
Erectile Dysfunction ◽  
Peak Systolic Velocity ◽  
Duplex Ultrasound ◽  
Arterial Disease ◽  
Duplex Sonography ◽  
Intracavernosal Injection ◽  
Specific Patient ◽  
Published Evidence ◽  
Diastolic Velocity ◽  
Penile Artery

Summary: Background: The extent of arterial disease in patients with erectile dysfunction (ED) non-responsive to intracavernosal injection of Alprostadil is of importance for therapeutic options. However, published evidence, in particular angiographically validated is scarce. Here we investigated arterial lesion patterns in this specific patient cohort by selective angiography. Patients and methods: A cohort of 239 patients received a clinical and duplex-sonographic workup for ED of suspected vascular origin. Duplex ultrasound of the cavernosal arteries was performed after intracavernosal injection of 10 μg Alprostadil. Consequently, standardized workup included grading of the erectile and determination of peak systolic velocity (PSV) and end-diastolic velocity (EDV) in both cavernosal arteries. PSV-values below 30 cm/sec indicated reduced arterial flow, whereas EDV-values above 15 cm/sec indicated a venous leak of the pudendal veins. All patients with suspected arterial ED based on duplex sonography underwent contrast-enhanced computed tomography. Endovascular therapy was carried out in ED patients not responsive or with significant side effects to PDE-5-inhibitors or Alprostadil by selective angiographic depiction of erection-related arteries. Results: 54 patients with a mean age of 61.2 (±9.8) years underwent angioplasty of erectionr elated arteries. Out of these 48/54 (89%) patients presented with an erection considered insufficient for penetration (E0-E3) subsequent to intracavernous application of 10 μg Alprostadil. 14/48 (29%) patients had bilateral arterial obstructions and 34/48 (71%) had unilateral disease. Commonly affected was the internal pudendal artery (n = 31, 65%), followed closely by the common penile artery (n = 30, 64%). The least affected arteries were the dorsal penile (n = 6, 13%), hypogastric (n = 4, 8%), common iliac (n = 4, 8%), cavernosal (n = 4, 8%), and inferior gluteal (n = 1, 2%) arteries. Conclusions: Arterial obstructions amenable to endovascular revascularization are frequent in patients non-responsive to intracavernosal prostaglandin administration. Therapeutic strategies in ED patients non-responsive to conservative measures should therefore consider endovascular treatment opportunities.

Penile Artery Shunt Syndrome: A Novel Cause of Erectile Dysfunction after Penile Revascularization Surgery

2014 ◽  
Vol 11 (9) ◽  
pp. 2338-2341 ◽  
Author(s):  
Jonathan G. Pavlinec ◽  
Tariq S. Hakky ◽  
Christopher Yang ◽  
Kamal Massis ◽  
Ricardo Munarriz ◽  
...  
Keyword(s):  
Erectile Dysfunction ◽  
Penile Artery ◽  
Penile Revascularization ◽  
Revascularization Surgery

scholarly journals MYPT1 reduction is a novel pathogenic factor of erectile dysfunction

2020 ◽  
Author(s):  
Wei Zhao ◽  
Jie Sun ◽  
Liang-Yu Yao ◽  
Ye-Qiong Li ◽  
Cai-Ping Chen ◽  
...  
Keyword(s):  
Erectile Dysfunction ◽  
Knockout Mice ◽  
Smooth Muscles ◽  
Muscle Dysfunction ◽  
Pathogenic Factor ◽  
E3 Ligases ◽  
Penile Artery ◽  
Novel Strategy ◽  
Underlying Mechanisms ◽  
Smooth Muscle Dysfunction

Abstract Erectile dysfunction (ED) is closely associated with smooth muscle dysfunction, but its underlying mechanisms remains incompletely understood. We here reported that the reduced expression of myosin phosphatase target subunit 1 (MYPT1), the main regulatory unit of myosin light chain phosphatase, was critical for the development of vasculogenic ED. Male MYPT1 knockout mice had reduced fertility and the penises displayed abolished erections as evidenced by reduced intracavernous pressure (ICP). The penile smooth muscles of the knockout mice displayed enhanced contractility and resistant relaxation. We further identified a natural compound lotusine that increased the MYPT1 expression by inhibiting SIAH1/2 E3 ligases-mediated protein degradation. This compound sufficiently restored the ICP and improved histological characters of the penile artery of Mypt1 haploinsufficiency mice. In diabetic ED mice (db/db), the decreased expression of MYPT1 was measured, and ICP was restored by lotusine treatment. We conclude that the reduction of MYPT1 is the major pathogenic factor of vasculogenic ED. The restoration of MYPT1 by lotusine improved the function of injured penile smooth muscles, and could be a novel strategy for ED therapy.

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