scholarly journals Surgical methods to correct arteriogenic erectile dysfunction

2021 ◽  
Vol 22 (3) ◽  
pp. 34-43
Author(s):  
A. V. Bystrenkov ◽  
E. A. Povelitsa ◽  
V. N. Podgaisky ◽  
A. E. Povelitsa
Keyword(s):  
Erectile Dysfunction ◽  
Erectile Function ◽  
Study Objective ◽  
Arterial Perfusion ◽  
Endovascular Interventions ◽  
Combined Operations ◽  
Reconstructive Operations ◽  
Surgical Methods ◽  
Comprehensive Examination ◽  
The Republic

The study objective is to define the state of the problem of surgical methods for the treatment arteriogenic forms of erectile dysfunction (ED) in the Republic of Belarus, to systematize surgical methods for the correction of arteriogenic ED, to evaluate the results of interventional, surgical and combined methods of the treatment of arteriogenic forms of ED in the Republic of Belarus.Materials and methods. A comprehensive examination was carried out 65 men with arteriogenic ED (average age 52.2 ± 2.2 year, International Index of Erectile Function – 9.6 ± 1.3 points; the hardness of erection – 2.2 ± 0.3 according to the Yunem scale) included ultrasound, multispiral computed angiography, as results of stenosing and occlusive lesions of the aorto-iliac segments, internal pudendal artery (IPA) and distal branches were revealed. Of these, as a result of atherosclerotic damage to arteries – 59 (91 %) patients, hypoplasia of the IPA – 4 (6 %) patients and in 2 (3 %) – cases due to post-traumatic damage to the IPA during fracture of the pelvic bones. Pro- and retrospectively performed analysis of the results of endovascular, surgical and combined correction of chronic arterial insufficiency of penis. Based on the results of the study, blood flow deficiency was simulated in order to determine the possible level and method of its elimination. Subsequently, 34 reconstructive operations were performed, including endovascular: superselective stenting of IPA – in 1 case, angioplasty of IPA – one-bilateral – in 4 cases, stenting of the iliac arteries – in 14 cases, in 4 cases – aorto-femoral bypass or prosthetics. Microsurgical operations with epigastric-penile anastomosis were performed in 9 cases (Virag II type in 8 cases, Michal II – Scharlip in 1 case), including in 3 cases as a second stage to increase arterial perfusion of penis after endovascular interventions. In 3 cases, for severe arteriogenic ED and endothelial insufficiency, endophalloprosthesis was implanted (AMS-Spectra).Results. According to the results of testing of patients after endovascular intervention or microsurgical reconstruction, as well as after a two-stage correction that included both methods, patients showed a statistically significant improvement in erectile function on the scale of the International Index of Erectile Function – from 9–12 points (10.0 ± 0.31 points) before surgery to 16–19 points (17.5 ± 0.25 points) 12 months after surgery (p = 0.0009).Conclusions. Interventional methods of correction after micro surgical and combined operations in patients with arteriogenic ED allow achieving a satisfactory result during the first year after surgery, provided that patients are carefully selected using a comprehensive examination, including various ultrasound techniques, multispiral computed angiography, as well as the selection of an appropriate type of revascularization.

scholarly journals Comparative results of nerve-sparing robotic-assisted prostatectomy

2021 ◽  
Vol 22 (3) ◽  
pp. 44-48
Author(s):  
E. V. Shpot’ ◽  
D. V. Chinenov ◽  
Ya. N. Chernov ◽  
A. Yu. Votyakov ◽  
E. N. Gasanov ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Prostate Cancer ◽  
Erectile Dysfunction ◽  
Erectile Function ◽  
Surgical Margin ◽  
Localized Prostate Cancer ◽  
Study Objective ◽  
Nerve Preservation ◽  
Quality Of Life Scale

Background. Considering decreasing age of patients with prostate cancer, increasing cancer alertness of first-line doctors as well as increased frequency of radical prostatectomies (RP), the problem of preservation of erectile function (EF) is vitally important (erectile dysfunction develops in 25–75 % of all patients who underwent surgery).The study objective is to analyze preservation of EF after RP depending on the type of endoscopic access and nerve preservation.Materials and methods. Between February of 2015 and February of 2016, in the Urology Clinic of the Sechenov University, 507 RPs were performed; the retrospective single-center study included 231 patients with localized prostate cancer. Surgery was performed with the following accesses: laparoscopic, extraperitoneal laparoscopic, and robotic. Indications for nerve preservation were formulated based on the Briganti nomogram, Partin table as well as patient’s desire to preserve EF. Further evaluation of EF was performed using the International Index of Erectile Function (IIEF5), evaluation of quality of life – using the QoL (Quality of Life) scale.Results. RP with nerve preservation was performed in 150 patients. Surgical time and blood loss did not significantly differ for surgeries with and without nerve preservation (р = 0.064 and р = 0.073 respectively). Pathomorphological examination showed that in all cases (n = 231) integrity of the prostatic capsule and negative surgical margin were achieved. Frequent significant erectile dysfunction and full loss of EF were observed in patients after RP without nerve preservation compared to the group with preserved neurovascular bundles (5.0 (0.0–10.0) points compared to 6.5 (0.8–19.0) points per the IIEF5 scale, р = 0.271): 96.2 % versus 72.2 % (p <0.001). Nerve preservation significantly improved quality of life: 1.63 ± 1.16 points versus 1.88 ± 1.02 points per the QoL scale (р = 0.035).Conclusions. The best results were achieved in the robotic access group. Surgery with nerve preservation decreased frequency of EF loss. This benefit in conjunction with the radical nature of the operative intervention allows to consider RP techniques with nerve preservation as reasonable approach to erectile dysfunction prevention in patients with localized prostate cancer.

1417: Mesenchymal Stem Cells Alone or Modified with ENOS Restore Erectile Function in the Aged Rat: Cell-Based Gene Therapy for Erectile Dysfunction

2004 ◽  
Vol 171 (4S) ◽  
pp. 373-373
Author(s):  
Trinity J. Bivalacqua ◽  
Mustafa F. Usta ◽  
Hunter C. Champion ◽  
Weiwen Deng ◽  
Philip J. Kadowitz ◽  
...  
Keyword(s):  
Stem Cells ◽  
Gene Therapy ◽  
Mesenchymal Stem Cells ◽  
Erectile Dysfunction ◽  
Erectile Function ◽  
Aged Rat

1503-P: Assessment of Erectile Dysfunction in Men with Type 2 Diabetes Mellitus Using the International Index of Erectile Function (IIEF) Questionnaire

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 1503-P ◽  
Author(s):  
MUKULESH GUPTA ◽  
KUMAR PRAFULL CHANDRA ◽  
ARUNKUMAR PANDE ◽  
RAJIV AWASTHI ◽  
AJOY TEWARI ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Erectile Dysfunction ◽  
Erectile Function

scholarly journals Effects of renal transplantation on erectile dysfunction: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Irham Arif Rahman ◽  
Nur Rasyid ◽  
Ponco Birowo ◽  
Widi Atmoko
Keyword(s):  
Systematic Review ◽  
Erectile Dysfunction ◽  
Kidney Transplantation ◽  
Renal Transplantation ◽  
End Stage Renal Disease ◽  
Erectile Function ◽  
Meta Analysis ◽  
Post Transplantation ◽  
Stage Renal Disease ◽  
End Stage

AbstractErectile dysfunction (ED) is a major global health burden commonly observed in patients with end-stage renal disease (ESRD). Although renal transplantation improves the problem in some patients, it persists in ≈20–50% of recipients. Studies regarding the effects of kidney transplantation on ED present contradictory findings. We performed a systematic review to summarise the effects of kidney transplantation on ED. A systematic literature search was performed across PubMed, Cochrane, and Scopus databases in April 2020. We included all prospective studies that investigated the pre and posttransplant international index of erectile function (IIEF-5) scores in recipients with ED. Data search in PubMed and Google Scholar produced 1326 articles; eight were systematically reviewed with a total of 448 subjects. Meta-analysis of IIEF-5 scores showed significant improvements between pre and post transplantation. Our findings confirm that renal transplantation improves erectile function. Furthermore, transplantation also increases testosterone level. However, the evidence is limited because of the small number of studies. Further studies are required to investigate the effects of renal transplantation on erectile function.

Safety and feasibility of bioabsorbable everolimus-eluting stents for patients with internal pudendal artery-related arteriogenic erectile dysfunction (PERFECT-ABSORB)

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T.D Wang ◽  
W.J Lee ◽  
H.J Chang ◽  
Y.K Chang ◽  
W.J Chen
Keyword(s):  
Erectile Dysfunction ◽  
Ct Angiography ◽  
Erectile Function ◽  
Clinical Success ◽  
Restenosis Rate ◽  
Internal Pudendal Artery ◽  
Binary Restenosis ◽  
Angiographic Restenosis ◽  
Invasive Angiography ◽  
Arterial Lesions

Abstract Background Obstructive pelvic arterial lesions are present in ∼70% of patients aged &gt;50 years and having erectile dysfunction. The internal pudendal artery, with an average diameter of 2.5 mm, is the segment where ∼40% of pelvic obstructive lesions are located. Our prior experience showed a 40–50% binary restenosis rate for drug-eluting stents in internal pudendal artery. In this PERFECT-ABSORB study, we would like to assess the feasibility and safety of the bioresorbable everolimus-eluting vascular scaffolds (BVS), facilitated by intravascular optical coherence tomography (OCT), in patients with erectile dysfunction and concomitant internal pudendal artery stenoses. Methods This prospective, unblinded, single-arm, single-center study was a first-in-man proof-of-concept study. Patients with erectile dysfunction and obstructive pelvic arterial lesions (unilateral diameter stenosis ≥70% or bilateral stenoses ≥50%) in the internal pudendal arteries with reference vessel diameter ≥2.5 mm and ≤4.0 mm and a target-lesion length ≤30 mm in the pelvic computed tomographic (CT) angiography were recruited. All subjects underwent pelvic CT angiography, penile Doppler ultrasonography, and invasive pelvic angiography with OCT at baseline and 8 months after intervention. The primary endpoint is CT angiographic binary restenosis (≥50% lumen diameter stenosis) at 8 months. The secondary endpoints include sustained clinical success in erectile function (International Index for Erectile Function-5 [IIEF-5] score ≥22 or change in IIEF-5 ≥4 and without a later decline by ≥4) at 12 months. Results Eighteen patients were enrolled (mean age, 61.8±5.6 years; range, 52–71 years). The IIEF-5 score at baseline was 7.3±3.6, with a median duration of erectile dysfunction of 3 years. A total of 31 BVSs were implanted: seven patients were treated with one BVS, 9 patients with 2 BVSs, and 2 patients with 3 BVSs. All implanted BVSs were of 2.5 mm in diameter. Among the 17 patients undergoing 8-month follow-up pelvic CT angiography and invasive angiography (one not done due to colon cancer diagnosed later), binary CT angiographic restenosis developed in 7 (37%) of 19 lesions and 7 (41%) of 17 patients. After excluding those with lesions &gt;30 mm (per-protocol analysis), binary CT angiographic restenosis developed in 5 (31%) of 16 lesions and 5 (36%) of 14 patients. Binary restenosis assessed by invasive angiography and OCT was the same as assessed by pelvic CT angiography. Among the 17 patients, 9 (53%) achieved sustained clinical success in erectile function 12 months following the procedure. All of them did not develop binary restenosis. Conclusions We for the first time demonstrated that BVS+OCT strategy for internal pudendal artery stenosis was safe and able to achieve 30% restenosis rate in lesions ≤30 mm in length. Compared to our prior experience, BVS+OCT strategy was associated with a numerically lower restenosis rate. Funding Acknowledgement Type of funding source: None

scholarly journals Exercise prevents Western diet-associated erectile dysfunction and coronary artery endothelial dysfunction: response to acute apocynin and sepiapterin treatment

2013 ◽  
Vol 305 (4) ◽  
pp. R423-R434 ◽  
Author(s):  
Justin D. La Favor ◽  
Ethan J. Anderson ◽  
Jillian T. Dawkins ◽  
Robert C. Hickner ◽  
Christopher J. Wingard
Keyword(s):  
Erectile Dysfunction ◽  
Coronary Artery ◽  
Exercise Training ◽  
Erectile Function ◽  
Dietary Intervention ◽  
Ex Vivo ◽  
Control Diet ◽  
Western Diet ◽  
Treadmill Running ◽  
Aerobic Exercise Training

The aim of this study was to investigate aerobic exercise training as a means to prevent erectile dysfunction (ED) and coronary artery disease (CAD) development associated with inactivity and diet-induced obesity. Male Sprague-Dawley rats were fed a Western diet (WD) or a control diet (CD) for 12 wk. Subgroups within each diet remained sedentary (Sed) or participated in aerobic interval treadmill running throughout the dietary intervention. Erectile function was evaluated under anesthesia by measuring the mean arterial pressure and intracavernosal pressure in response to electrical field stimulation of the cavernosal nerve, in the absence or presence of either apocynin, an NADPH oxidase inhibitor, or sepiapterin, a tetrahydrobiopterin precursor. Coronary artery endothelial function (CAEF) was evaluated ex vivo with cumulative doses of ACh applied to preconstricted segments of the left anterior descending coronary artery. CAEF was assessed in the absence or presence of apocynin or sepiapterin. Erectile function ( P < 0.0001) and CAEF ( P < 0.001) were attenuated in WD-Sed. Exercise preserved erectile function ( P < 0.0001) and CAEF ( P < 0.05) within the WD. Erectile function ( P < 0.01) and CAEF ( P < 0.05) were augmented by apocynin only in WD-Sed, while sepiapterin ( P < 0.05) only augmented erectile function in WD-Sed. These data demonstrate that a chronic WD induces impairment in erectile function and CAEF that are commonly partially reversible by apocynin, whereas sepiapterin treatment exerted differential functional effects between the two vascular beds. Furthermore, exercise training may be a practical means of preventing diet-induced ED and CAD development.

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