Low-Intensity Extracorporeal Shockwave Therapy – A New Approach in the Treatment of Erectile Dysfunction after Radical Prostatectomy

2017 ◽  
Vol 10 (2) ◽  
pp. 104-110
Author(s):  
Boyan A. Stoykov ◽  
Nikolay H. Kolev ◽  
Rumen P.Kotsev ◽  
Fahd Al-Shargabi ◽  
Pencho P. Genov ◽  
...  
Keyword(s):  
Erectile Dysfunction ◽  
Erectile Function ◽  
Control Group ◽  
Nerve Sparing ◽  
Low Intensity ◽  
The Third ◽  
Extracorporeal Shock Wave ◽  
Number Of Patients ◽  
Group 2 ◽  
Group 1

Summary The experience accumulated with low-intensity extracorporeal shock wave therapy (LI-ESWT) from international clinical trials has demonstrated its safety, efficacy and good tolerance in treatment of erectile dysfunction (ED). The aim of this retrospective study was to investigate the effect of LI-ESWT in patients with ED after bilateral nerve sparing radical surgery for prostate cancer. Twenty-seven patients underwent bilateral nerve sparing radical retropubic prostatectomy (BNSRRP) at the clinic of urology of the university hospital in Pleven between January 2016 and December 2016. Twenty-one of these patients had pre-operative preserved erectile function (EF), as reported according to the International Index of Erectile Function (IIEF-5). Postoperatively, these 21 patients experienced a mild (18-21 points) impairment of EF. In 10 patients (group 1), LI-ESWT was performed. The procedure was performed once a week for 6 weeks with a LI-ESWT (BTL 6000 SWT Topline) instrument. The reading was obtained with IIEF-5 on the third and sixth month after the end of therapy. The other 11 patients (group 2) were used as a control group and did not receive treatment. In 5 patients in group 1, a recovery of EF (> 21 points) as per IIEF-5 was recorded at the third month after treatment. In two patients, the same score was recorded at the sixth month. No improvement was seen in three men in group 1. In the controls (group 2), a spontaneous EF improvement in four patients at sixth month was registered. Despite the small number of patients and their short-term follow-up, our initial results indicate that LI-ESWT is effective, safe and well-tolerated. It could be an alternative for early penis rehabilitation in patients who have undergone BNSRRP.

scholarly journals Effect of ADMA levels on severity of erectile dysfunction in chronic kidney disease and other risk factors

2016 ◽  
Vol 10 (1-2) ◽  
pp. 41 ◽  
Author(s):  
Kaan Gökçen ◽  
Hakan Kılıçarslan ◽  
Burhan Coşkun ◽  
Alparslan Ersoy ◽  
Onur Kaygısız ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Erectile Dysfunction ◽  
Kidney Disease ◽  
Erectile Function ◽  
Serum Prolactin ◽  
Control Group ◽  
Total Testosterone ◽  
Group 2 ◽  
And Control ◽  
Group 1

Introduction: Hormonal, neurogenic, vasculogenic, and psychogenic impairments, as well as endothelial dysfunction may play a role in erectile dysfunction (ED) in patients with chronic kidney disease (CKD). Asymmetrical dimethylarginine (ADMA) is an inhibitor of nitric oxide, which is the key element of ED. ADMA levels are increased in CKD. We aimed to evaluate the effect of serum ADMA, prolactin, testosterone, and hemoglobin levels on erectile function of patients with CKD and control subjects.Methods: A total of 42 men with CKD and 25 age-matched controls were enrolled. The patients with CKD were categorized into group 1 and group 2 based on whether they had ED according to their response to International Index of Erectile Function questionnaire (IIEF-EFD). Group 3 was a control group. Serum ADMA, total testosterone prolactin, and hemoglobin levels of the patients were evaluated.Results: Serum ADMA, testosterone, and hemoglobin levels were similar between group 1 and 2, serum prolactin level was significantly high in group 1 than in group 2 or 3 (control group). There was no correlation between ADMA levels and IIEF-EFD scores of patients with CKD.Conclusions: The results of this study suggest serum ADMA level is not related with ED in patients with CKD. Also, low testosterone and hemoglobin levels were not significant factors. High levels of serum prolactin are related with ED in patients with CKD.

scholarly journals Influence of Linseed and Fish Oil on Metabolic and Immunological Indicators of Laying Hens

2008 ◽  
Vol 77 (1) ◽  
pp. 39-44 ◽  
Author(s):  
M. Švedová ◽  
L. Vaško ◽  
A. Trebunová ◽  
R. Kašteľ ◽  
M. Tučková ◽  
...  
Keyword(s):  
Fish Oil ◽  
Laying Hens ◽  
Hdl Cholesterol ◽  
High Density Lipoproteins ◽  
Control Group ◽  
Experimental Animals ◽  
The Third ◽  
Fish Group ◽  
Group 2 ◽  
Group 1

The metabolic and immunological indicators were determined in the blood of laying hens of ISA BROWN hybrid divided into three groups, the control group and two experimental groups. The administration of n-3 polyunsaturated fatty acids (PUFA) in the form of linseed (Group 1) and fish oil (Group 2) and α-tocopherol as antioxidant to laying hens resulted in a significant increase in concentrations of high density lipoproteins (HDL) cholesterol (P < 0.05), eicosapentaenoic (EPA), docosahexaenoic (DHA) and α-linolenic acids (AA) in blood in comparison to the control group. Significantly lower levels of cholesterol (CHOL) were determined in both experimental groups at the third sampling (P < 0.05) and arachidonic acid (AA) in the fish group (P < 0.01). The metabolic activity of phagocytes and polyclonal activation of lymphocytes showed no significant differences and remained within the physiological range. Oral administration of n-3 PUFA showed no significant increase of the immune response of experimental animals.

scholarly journals Low intensity shock wave therapy for erectile dysfunction: 6 months followup results

2017 ◽  
Vol 7 (3) ◽  
pp. 5-13
Author(s):  
Igor A Korneyev ◽  
Ivan V Telegin ◽  
Ivan V Davydov ◽  
Artem V Matveev ◽  
Dmitrij V Rubanov ◽  
...  
Keyword(s):  
Shock Wave ◽  
Erectile Dysfunction ◽  
Radical Prostatectomy ◽  
Adverse Events ◽  
Individual Variability ◽  
Nerve Sparing ◽  
Shock Wave Therapy ◽  
Low Intensity ◽  
Extracorporeal Shock Wave ◽  
Patient Reported

Introduction. Low intensity extracorporeal shock wave therapy (ESWT) is a novel promising method of treatment for men with erectile dysfunction (ED). The efficacy of ESWT is not clearly determined and need further investigation. Aim of the study: To investigate 6 months followup efficacy and safety results from ESWT trial in patients with ED. Patients and methods. This open-label, longitudinal observational study investigated 6 months followup results in 19 men (mean age = 59.5 years) with organic ED (including 6 (32%) patients with type 2 diabetes mellitus and 6 (32%) patients after nerve-sparing radical prostatectomy) treated with 5-session weekly ESWT protocol using DornierAries delivery system (7500 shock waves, 1500 each session, 4 Hz). Information about adverse events was recorded. Effectiveness was assessed according to the International Index of Erectile Function and Sexual Health Inventory for Men after the 5th ESWT session and also in 1, 3 and 6 months. Results. No patient reported treatment-related adverse events. In 12 (63%), 11 (57%), 11 (57%) and 9 (47%) patients IIEF increased after the 5th ESWT session (also in 2 (33%) men with ED caused by radical prostatectomy), and in 1, 3, 6 months after treatment respectively, so the mean IIEF score in the group has become higher (p = 0.003, p = 0.050, p = 0.022, р > 0.1 respectively) as well as the IIEF general satisfaction domain score (p = 0.006 и p = 0.014, р = 0.011 и p = 0.028, respectively). Mean SHIM score growth was significantly higher after the 5th ESWT session only (р = 0.020), also in patients with diabetic ED (р = 0.041). Individual variability of both IIEF and SHIM scores after treatment was high, with IIEF lower in patients with advanced age (р = 0.015). Conclusions. In 6 months followup ESWT was safe in all and effective in many patients with ED. High individual variability of treatment efficacy needs further evaluation. (For citation: Korneyev IA, Telegin IV, Davydov IV, et al. Low intensity shock wave therapy for erectile dysfunction: 6 months followup results. Urologicheskie vedomosti. 2017;7(3):5-13. doi: 10.17816/uroved735-13).

Evaluation of oxidative stress and antioxidant activity in women with moderate and severe preeclampsia in the third trimester of pregnancy and their newborns

2020 ◽  
Vol 65 (12) ◽  
pp. 733-737
Author(s):  
Irina Gennadievna Popova ◽  
O. G. Sitnikova ◽  
S. B. Nazarov ◽  
R. I. Sadov ◽  
I. A. Panova ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Antioxidant Activity ◽  
Free Radical Oxidation ◽  
Control Group ◽  
Third Trimester ◽  
Radical Oxidation ◽  
The Third ◽  
Uncomplicated Pregnancy ◽  
Group 2 ◽  
Group 1

We examined 66 women who were 22-40 weeks pregnant and their newborns. Of these, 15 women with moderate PE were in group 1, 22 women with severe PE were in group 2, and 55 women with uncomplicated pregnancy without hypertensive disorders were in the control group. Blood was taken from women when they were admitted to the clinic, and newborns ‘ blood was taken for 3-5 days of life. Free radical oxidation and antioxidant activity were evaluated by induced chemiluminescence. It was found that in patients with severe and moderate preeclampsia, the development of oxidative stress is accompanied by a weakening of antioxidant activity. In newborns born to mothers with preeclampsia, oxidative stress is accompanied by a compensatory increase in antioxidant activity.

scholarly journals Low-intensity extracorporeal shock wave therapy of vasculogenic erectile dysfunction - three-week treatment in a cohort of North Italian patients

2018 ◽  
Vol 146 (9-10) ◽  
pp. 549-553 ◽  
Author(s):  
Goran Arandjelovic ◽  
Fedra Gottardo ◽  
Ivan Ignjatovic
Keyword(s):  
Shock Wave ◽  
Erectile Dysfunction ◽  
Doppler Ultrasound ◽  
Erectile Function ◽  
Extracorporeal Shock Wave Therapy ◽  
Shock Wave Therapy ◽  
Low Intensity ◽  
Extracorporeal Shock Wave ◽  
Vasculogenic Erectile Dysfunction

Introduction/Objective. Although phosphodiesterase 5 (PDE 5) inhibitors represent the gold standard for medical treatment of erectile dysfunction (ED), they are not curative. Over the recent years, low-intensity extracorporeal shock wave therapy (LI-ESWT) has been proposed as a valid non-invasive therapy approach for ED. The aim of our work is to assess the shortened, three-week low-intensity extracorporeal shock wave therapy of vasculogenic ED. Methods. The study involved 32 patients with an International Index of Erectile Function (IIEF) score between 5 and 20, and whose vasculogenic ED had been proven through Doppler ultrasound. All the patients had a washout period of one month after previous therapy and agreed to discontinue the PDE5-I therapy during the follow-up. The LI-ESWT was applied for three weeks, twice weekly, without repeating. The patients were evaluated at baseline, after one, three, and six months with the IIEF, Doppler ultrasound, and the Beck Depression Inventory. Results. All investigated parameters (International Index of Erectile Function, Beck Depression Inventory and penile Doppler ultrasound parameters) showed statistically significant improvement just one month after the treatment, compared to pre-treatment values, in all investigated domains. The international index of erectile function passed from baseline values of 12.75 ? 4.62 to 14.87 ? 5.04 at one month after treatment (p < 0.01). This trend remained positive in IIEF and all the parameters tested at the three-month and six-month follow-up. Conclusion. The shortened three-week low-intensity shock wave treatment of vasculogenic erectile dysfunction proved to be clinically effective.

Comparing the effects and safety of dorzolamide hydrochloride + timolol maleate versus brimonidine after neodymium-doped yttrium aluminium garnet laser capsulotomy posterior capsule opacification

2021 ◽  
pp. 112067212110521
Author(s):  
Kaan Çakmak ◽  
Hasan Erbil ◽  
Cem Mesci ◽  
Şafak Korkmaz
Keyword(s):  
Intraocular Pressure ◽  
Yttrium Aluminium Garnet ◽  
Control Group ◽  
Timolol Maleate ◽  
The Third ◽  
Yttrium Aluminium ◽  
Group 2 ◽  
Dorzolamide Hydrochloride ◽  
Yttrium Aluminium Garnet Laser ◽  
Group 1

Aim Posterior capsular opacification is treated using neodymium-doped yttrium aluminium garnet laser capsulotomy that leads to increased intraocular pressure. Here, we compare the effects of dorzolamide hydrochloride + timolol maleate versus brimonidine on intraocular pressure. We also investigate their side effects after neodymium-doped yttrium aluminium garnet laser capsulotomy. In these patients, there are no prior studies comparing the results of these two drugs. Materials Ninety patients with posterior capsule opacification contributed to the study. They received yttrium aluminium garnet laser capsulotomy. After yttrium aluminium garnet laser capsulotomy, they were randomized into three groups. Group 1 received dorzolamide hydrochloride + timolol maleate; Group 2 took brimonidine; and Group 3, the control group, took no drug. Group 1 took dorzolamide hydrochloride + timolol maleate eye drops 1 h before the procedure and on the third hour of the first day and two times per day between the second and the seventh days. Group 2 took brimonidine eye drops 1 h before the procedure and on the third hour of the first day, two times per day between the second and the seventh days. Results Brimonidine had a similar side effect profile to the fix combination. Intraocular pressure on the first ( p = 0.87) and third days ( p = 0.124) were similar in Group 1 (dorzolamide hydrochloride + timolol maleate), Group 2 (brimonidine) and the control group. The mean intraocular pressure value of the control group was significantly higher than Groups 1 and 2 because the anti-glaucomatous effects of the drugs become prominent on the seventh day ( p = 0.041). In Group 1 and Group 2, intraocular pressure was significantly lower than the control group on the seventh day ( p = 0.041). Stinging, itching, hyperemia and Tyndall rates were similar in Group 1, Group 2 and the control group. Watery eyes were less common in the brimonidine group than in the dorzolamide hydrochloride–timolol maleate and the control groups on the seventh day ( p = 0.02). Brimonidine also significantly lowered the chemosis rate on the third ( p = 0.04) and seventh ( p = 0.03) days. Conclusion We suggest that brimonidine and a combination of dorzolamide + timolol are similarly effective at reducing eye pressure for routine cases. In cases where intraocular pressure attacks might be at higher risk, using the dorzolamide + timolol combination would be more appropriate.

scholarly journals Combined Therapy with Extracorporeal Shock Wave and Adipose-Derived Mesenchymal Stem Cells Remarkably Improved Acute Ischemia-Reperfusion Injury of Quadriceps Muscle

2018 ◽  
Vol 2018 ◽  
pp. 1-14 ◽  
Author(s):  
Tsung-Cheng Yin ◽  
Re-Wen Wu ◽  
Jiunn-Jye Sheu ◽  
Pei-Hsun Sung ◽  
Kuan-Hung Chen ◽  
...  
Keyword(s):  
Shock Wave ◽  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Ischemia Reperfusion ◽  
Quadriceps Muscle ◽  
Control Group ◽  
Opposite Pattern ◽  
Extracorporeal Shock Wave ◽  
Group 2 ◽  
Group 1

Extracorporeal shock wave (ECSW) and adipose-derived mesenchymal stem cells (ADMSCs) have been recognized to have capacities of anti-inflammation and angiogenesis. We tested the hypothesis that ECSW and ADMSC therapy could attenuate ischemia-reperfusion- (IR-) induced thigh injury (femoral artery tightened for 6 h then the tightness was relieved) in rats. Adult male SD rats (n=30) were divided into group 1 (sham-control), group 2 (IR), group 3 (IR + ECSW/120 impulses at 0.12 mJ/mm2 given at 3 h/24 h/72 h after IR), group 4 (allogenic ADMSC/1.2 × 106 cell intramuscular and 1.2 × 106 cell intravenous injections 3 h after IR procedure), and group 5 (ECSW + ADMSC). At day 7 after the IR procedure, the left quadriceps muscle was harvested for studies. At 18 h after the IR procedure, serum myoglobin/creatine phosphokinase (CPK) levels were highest in group 2, lowest in group 1, and with intermediate values significantly progressively reduced in groups 3 to 5 (all p<0.0001). By day 5 after IR, the mechanical paw-withdrawal threshold displayed an opposite pattern of CPK (all p<0.0001). The protein expressions of inflammatory, oxidative-stress, apoptotic, fibrotic, DNA-damaged, and mitochondrial-damaged biomarkers and cellular expressions of inflammatory and DNA-damaged biomarkers exhibited an identical pattern of CPK among the five groups (all p<0.0001). The microscopic findings of endothelial-cell biomarkers and number of arterioles expressed an opposite pattern of CPK, and the angiogenesis marker was significantly progressively increased from groups 1 to 5, whereas the histopathology showed that muscle-damaged/fibrosis/collagen-deposition areas exhibited an identical pattern of CPK among the five groups (all p<0.0001). In conclusion, ECSW-ADMSC therapy is superior to either one applied individually for protecting against IR-induced thigh injury.

Effects of Ultrasound Modes on Mandibular Osteodistraction

2008 ◽  
Vol 87 (10) ◽  
pp. 953-957 ◽  
Author(s):  
T.H. El-Bialy ◽  
R.F. Elgazzar ◽  
E.E. Megahed ◽  
T.J. Royston
Keyword(s):  
Bone Formation ◽  
Control Group ◽  
Pulsed Ultrasound ◽  
Bone Fracture Healing ◽  
Low Intensity Pulsed Ultrasound ◽  
Low Intensity ◽  
Group 3 ◽  
Group 2 ◽  
Late Stages ◽  
Group 1

Previous studies have shown that therapeutic pulsed ultrasound (pulsed) has superior stimulatory effect on bone fracture healing compared with continuous ultrasound (continuous). Our predictive hypothesis was that pulsed ultrasound can produce better bone formation during mandibular osteodistraction than continuous ultrasound. Thirty-six New Zealand rabbits were divided into 3 groups of 12. Osteodistraction was performed at 3 mm/day for 5 days. Group 1 received pulsed, group 2 received continuous ultrasound, and group 3 was the control group (distraction only). Bone formation was assessed by quantitative bone density (QBD), mechanical testing, and histological examination. In the first 2 wks post-distraction, group 2 showed enhanced bone formation more than group 1 ( p < 0.05); however, in the 3rd and 4th wks, group 1 showed more bone formation than group 2 ( p < 0.05). Earlier stages of bone healing were enhanced more by continuous, whereas late stages were enhanced more by pulsed, ultrasound. Abbreviations: PULSED, low-intensity pulsed ultrasound; CONTINUOUS, low-intensity continuous ultrasound.

Whether Adding Vitamin D to Tadalafil 5 mg Treatment Is Useful in Patients with Erectile Dysfunction and Vitamin D Deficiency?

2021 ◽  
pp. 1-6
Author(s):  
Aykut Demirci ◽  
Murat Çakan ◽  
Murat Topçuoğlu
Keyword(s):  
Vitamin D ◽  
Erectile Dysfunction ◽  
Vitamin D Deficiency ◽  
Sexual Desire ◽  
Erectile Function ◽  
Phosphodiesterase Type 5 Inhibitors ◽  
Vitamin D Levels ◽  
Group 2 ◽  
Phosphodiesterase Type ◽  
Group 1

<b><i>Introduction:</i></b> Numerous factors such as endothelial disease and hormonal disorder cause the development of erectile dysfunction (ED). However, the relationship between vitamin D deficiency (VDD) and ED is unclear. Moreover, the benefit of vitamin D replacement on ED patients with VDD is uncertain. As far as we know, there is no study yet in the literature regarding the addition of vitamin D to phosphodiesterase type 5 inhibitors in the treatment of ED patients with VDD. In this study, we investigated whether adding vitamin D to daily tadalafil treatment would be beneficial in ED patients with VDD. <b><i>Methods:</i></b> A total of 111 patients with VDD accompanying ED were retrospectively evaluated between January 2016 and December 2019. Patients were divided into 2 groups according to the treatment they received. Group 1 (<i>n</i> = 58) was treated with daily oral tadalafil 5 mg, while group 2 (<i>n</i> = 53) received oral tadalafil 5 mg and 4,000 IU vitamin D3. Total International Index of Erectile Function-15 (IIEF-15) scores and vitamin D levels of the groups were compared at the end of the study. <b><i>Results:</i></b> The mean vitamin D level was increased statistically significant in group 2, but no difference was seen in group 1 (<i>p</i> &#x3c; 0.001 and <i>p</i> &#x3e; 0.05, respectively). There was a significant increase in median erectile function, orgasmic function, sexual desire, sexual satisfaction, and overall satisfaction scores in both groups (<i>p</i> &#x3c; 0.001). However, the increase in median erectile function and sexual desire scores was significantly higher in group 2 compared to group 1 at the end of the study (<i>p</i> = 0.01 and <i>p</i> &#x3c; 0.001, respectively). <b><i>Conclusion:</i></b> We found that adding vitamin D to 5 mg oral daily tadalafil treatment may have an additional positive effect on erectile function and sexual desire in ED patients with VDD.

scholarly journals Post-COVID-19 transient hypogonadism and erectile dysfunction

2021 ◽  
Vol 14 (3) ◽  
pp. 112-118
Author(s):  
F.R. Asfandiyarov ◽  
◽  
V.A. Kruglov ◽  
S.V. Vybornov ◽  
K.S. Seidov ◽  
...  
Keyword(s):  
Erectile Dysfunction ◽  
Testosterone Level ◽  
Erectile Function ◽  
Hormone Replacement ◽  
Severe Illness ◽  
Hormonal Profile ◽  
Group 2 ◽  
The Impact ◽  
Group 1

Introduction. The SARS-CoV-2 virus pandemic is one of the biggest public health challenges in the modern era. Currently, along with the continuing high incidence rate, the immediate and long-term consequences of COVID-19 are predictably becoming increasingly important. The impact of the COVID-19 on andrological health and erectile function has been studied insufficiently. The aim of this study was to assess the impact of COVID-19 infection on erectile function. Material and methods. From May 2020 to April 2021 44 men after COVID-19 pneumonia were consulted for decrease in libido, erectile function and the quality of sexual intercourse in three Astrakhan medical centers. The examination of patients included standard general clinical methods, hormonal profile studying (testosterone, luteinizing homone, prolactin) and number of standardized questionnaires. Results. No changes in the levels of luteinizing hormone and prolactin were observed. Total testosterone levels ranged from 8.0 to 14.8 nmol / L. According the testosterone level patients were divided into two groups. In group 1 patients testosterone level was 12.0 nmol/L and more, in group 2 patients – less than 12 nmol/L. In patients of the group 1 erectile dysfunction was regarded as one of the manifestations of asthenic syndrome and was relatively easily corrected by the administration of PDE-5 inhibitors and antiasthenic therapy. Patients of the group 2 had more severe complaints, «worse» scores on questionnaire scales and more significant asthenic syndrome. Discussion. The possible mechanisms of androgen deficiency and hormonal profile changes in those patients may be a direct damaging of gonadal cells by virus and nonspecific suppression of the hypothalamic-pituitary system caused by a severe illness. In some cases, testosterone preparations were prescribed to those patients to achieve a therapeutic effect. Conclusions. COVID infection may have a negative impact on erectile function. The main causes of this are decrease of testosterone level, endothelial dysfunction, and long-term asthenization. Those changes may be reversible by rehabilitation and drug correction. One should not rush to begin hormone replacement therapy. It makes sense to start treatment with antiasthenic drugs, and add testosterone preparations in the absence of an effect only. This study addresses only some aspects of the COVID-19 influence on the men's health. In the context of the ongoing pandemic and the inevitable increase in the number of ill patients, further comprehensive studies are needed to clarify all the details and organize adequate andrological care for these patients.

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