Neurturin enhances the recovery of erectile function following bilateral cavernous nerve crush injury in the rat

BACKGROUND: The molecular mechanisms responsible for the survival and preservation of function for adult parasympathetic ganglion neurons following injury remain incompletely understood. However, advances in the neurobiology of growth factors, neural development, and prevention of cell death have led to a surge of clinical interest for protective and regenerative neuromodulatory strategies, as surgical therapies for prostate, bladder, and colorectal cancers often result in neuronal axotomy and debilitating loss of sexual function or continence. In vitro studies have identified neurturin, a glial cell line-derived neurotrophic factor, as a neuromodulator for pelvic cholinergic neurons. We present the first in vivo report of the effects of neurturin upon the recovery of erectile function following bilateral cavernous nerve crush injury in the rat. METHODS: In these experiments, groups (n = 8 each) consisted of uninjured controls and animals treated with injection of albumin (blinded crush control group), extended release neurotrophin-4 or neurturin to the site of cavernous nerve crush injury (100 μg per animal). After 5 weeks, recovery of erectile function (treatment effect) was assessed by cavernous nerve electrostimulation and peak aortic pressures were measured. Investigators were unblinded to specific treatments after statistical analyses were completed. RESULTS: Erectile dysfunction was not observed in the sham group (mean maximal intracavernous pressure [ICP] increase of 117.5 ± 7.3 cmH(2)O), whereas nerve injury and albumin treatment (control) produced a significant reduction in ICP elevation of 40.0 ± 6.3 cmH(2)O. Neurturin facilitated the preservation of erectile function, with an ICP increase of 55% at 62.0 ± 9.2 cmH(2)O (p < 0.05 vs control). Extended release neurotrophin-4 did not significantly enhance recovery of erectile function with an ICP change of 46.9 ± 9.6. Peak aortic blood pressures did not differ between groups. No significant pre- and post-treatment weight differences were observed between control, neurotrophin-4 and neurturin cohorts. All animals tolerated the five-week treatment course. CONCLUSION: Treatment with neurturin at the site of cavernous nerve crush injury facilitates recovery of erectile function. Results support further investigation of neurturin as a neuroprotective and/or neuroregenerative agent facilitating functional recovery after cavernous or other pelvic autonomic nerve injuries

COVID Pandemic Impact on Healthcare Provision and Patient Psychosocial Distress: A Multi-National Cross-Sectional Survey among Asia-Pacific Countries

Abstract Purpose COVID pandemic significantly affected the delivery and maintenance of healthcare system, resulting in greater utilization of digital health interventions. Materials and Methods This multi-national cross-sectional survey was administered to clinicians working in major Asia-Pacific cities during the mandatory social lockdown period in June 2020. Clinical demographics and professional data, delivery of Andrology-related healthcare services, and patient distress based on validated questionnaires such as Depression and Anxiety Stress Scales (DASS) and Decisional Engagement Scale (DES) were collected. Results Telehealth medicine was instituted in all the centres with the majority of centres (92.9%) reported a 50% or more reduction in out-patient related services. The numbers of phone calls, emails correspondence and educational webinars have significantly increased. Despite the provision of reasons for changes in healthcare service and delay in surgery, more than half of the patients (57.1%) rated 2 on the DASS score for the item on patients over-react to situations, while a third of the patients (35.7%) scored a 2 for DASS item on patients being more demanding or unreasonable. The DES scores were more positive with most patients reported a score above 7 out of 10 in terms of items on accepting current arrangement (85.7%), confident in clinician decision-making about treatment (92.9%) and comfortable that the decision is consistent with their preferences (71.4%). Most patients (85.7%) indicated their preferences for more detailed information on healthcare provision. Conclusions Our study showed telehealth services were integrated early and successfully during the COVID pandemic and patients were generally receptive with minimal psychosocial distress

COVID Pandemic Impact on Healthcare Provision and Patient Psychosocial Distress: A Multi-National Cross-Sectional Survey among Asia-Pacific Countries

10.5534/wjmh.210033WORLD JOURNAL OF MENS HEALTH394797-80

Provision of Sexual Medicine Services During the Coronavirus Disease-2019 Pandemic: An Asia Pacific Society of Sexual Medicine Position Statement

The coronavirus disease-2019 (COVID-19) pandemic has caused an unprecedented healthcare crisis with various governmental healthcare policies enforced to redirect medical prioritization and minimize the spread of COVID19 infection. Recognizing that the COVID-19 crisis will be protracted, it is important that clinicians and the healthcare industry continue to adapt existing resources and review contingency plan amidst this uncertain and difficult times. The Asia Pacific Society of Sexual Medicine supports ongoing precautionary healthcare measures implemented by various institutions and governmental policies to contain and eliminate COVID19 infection. Clinicians are encouraged to modify and adapt various strategies that will continue to provide, support, and treat sexual health–related conditions in a safe and efficient manner. Chung E, Jiann BP, Nagao L, et al. Provision of Sexual Medicine Services During the Coronavirus Disease-2019 Pandemic: An Asia Pacific Society of Sexual Medicine Position Statement. J Sex Med 2020;XX:XXX–XXX

Provision of Sexual Medicine Services During the Coronavirus Disease-2019 Pandemic: An Asia Pacific Society of Sexual Medicine Position Statement

Abstract The coronavirus disease-2019 (COVID-19) pandemic has caused an unprecedented healthcare crisis with various governmental healthcare policies enforced to redirect medical prioritization and minimize the spread of COVID19 infection. Recognizing that the COVID-19 crisis will be protracted, it is important that clinicians and the healthcare industry continue to adapt existing resources and review contingency plan amidst this uncertain and difficult times. The Asia Pacific Society of Sexual Medicine supports ongoing precautionary healthcare measures implemented by various institutions and governmental policies to contain and eliminate COVID19 infection. Clinicians are encouraged to modify and adapt various strategies that will continue to provide, support, and treat sexual health–related conditions in a safe and efficient manner