A Research Documentation On Men's Sexual Health Disclosed

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The role of diallyl thiosulfinate associated with nuciferine and diosgenin in the treatment of premature ejaculation: a pilot study

Objective: To assess the efficacy and safety of an association of diallyl thiosulfinate with nuciferine and diosgenin in the treatment of a group of patients suffering from premature ejaculation (PE), primary or secondary to erectile dysfunction (ED). Materials and methods: From July 2015 to October 2016, 143 patients (mean age 25.3; range 18-39) affected by PE completed the study and were finally analyzed in this phase I study. All patients, after clinical assessment and laboratory evaluation were asked to take an association of diallyl thiosulfinate with nuciferine and diosgenin as oral tablet, once a day, on alternate days, for three months. At the baseline and after three months of treatment, each patient was asked to complete the following questionnaires: International Index of Erectile Function (IIEF-5), Premature Ejaculation Diagnostic Tool (PEDT), Male Sexual Health Questionnaire (MSHQ). Results: A statistical significant improvement in terms of erectile function, comparing the IIEF-5 value at baseline and follow-up visit was found (respectively IIEF-5: 8.7 vs 14.01; p < 0.001). Moreover, at follow-up visit, 97/143 men (67.8%) referred a subjective improvement of the erection quality and a better control of the ejaculation (PROs). The IELT improved too between the baseline evaluation and the follow-up visit (p < 0.001). Conclusion: In conclusion, our study, even if supported by preliminary results, showed how Diallyl Thiosulfinate, Nuciferine and Diosgenin is able to improve the control of ejaculation in patients suffering from PE, primary or secondary to ED without any significant adverse effects

Management of erectile dysfunction post-radical prostatectomy

© 2015 Saleh et al.Radical prostatectomy is a commonly performed procedure for the treatment of localized prostate cancer. One of the long-term complications is erectile dysfunction. There is little consensus on the optimal management; however, it is agreed that treatment must be prompt to prevent fibrosis and increase oxygenation of penile tissue. It is vital that patient expectations are discussed, a realistic time frame of treatment provided, and treatment started as close to the prostatectomy as possible. Current treatment regimens rely on phosphodiesterase 5 inhibitors as a first-line therapy, with vacuum erection devices and intraurethral suppositories of alprostadil as possible treatment combination options. With nonresponders to these therapies, intracavernosal injections are resorted to. As a final measure, patients undergo the highly invasive penile prosthesis implantation. There is no uniform, objective treatment program for erectile dysfunction post-radical prostatectomy. Management plans are based on poorly conducted and often underpowered studies in combination with physician and patient preferences. They involve the aforementioned drugs and treatment methods in different sequences and doses. Prospective treatments include dietary supplements and gene therapy, which have shown promise with there proposed mechanisms of improving erectile function but are yet to be applied successfully in human patients

An investigation into the link between vitamin D status, erectile dysfunction and cardiovascular risk factors in ageing men in New Zealand : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Nutritional Science at Massey University, Palmerston North, New Zealand

Background Cardiovascular disease (CVD) is the leading cause of death worldwide, particularly amongst ageing males. Prevention and/or early identification and effective intervention are essential in the fight against CVD. Erectile dysfunction (ED) is a prevalent and multi-factorial condition that is now accepted to be an early marker of subclinical CVD: the common denominator is endothelial dysfunction. Both the enzymatic capability for bioactivation of vitamin D and the vitamin D receptor (VDR) are expressed in endothelial cells and vitamin D may play a role in endothelial function. Vitamin D deficiency (serum 25-hydroxyvitamin D (25(OH)D) concentrations ˂50 nmol/L) is a worldwide pandemic and serum 25(OH)D levels ˂75 nmol/L may result in metabolic and vascular deterioration leading to endothelial dysfunction, ED and CVD. Assessment of erectile function can be used to identify otherwise asymptomatic men at high risk of developing clinical CVD, at a time when effective intervention may prevent, delay or reverse its progression. Vitamin D status may be associated with ED and CVD risk and could help improve erectile function and vascular health. Objectives The aim of this research was to investigate the postulated link between vitamin D status, ED, and CVD risk factors. The objectives were (1) to assess the prevalence of ED (using the 5-item International Index of Erectile Function (IIEF-5)) and its associated sociodemographic, lifestyle, and medical correlates in New Zealand (NZ) men aged 40-70 years; (2) to investigate the relationship between vitamin D status (serum 25(OH)D concentration), ED and other CVD risk factors in men aged 40-70 years living in the Manawatu region of NZ; and (3) to examine the impact of common VDR gene (VDR) polymorphisms on this relationship. Method Two thousand men aged 40-70 years were randomly selected from the NZ Electoral Roll and sent an anonymous postal survey designed to assess the prevalence of ED and its sociodemographic, lifestyle, and medical risk factors. Six hundred men aged 40-70 years living in the Manawatu region were randomly selected from the NZ Electoral Roll and invited to participate in an observational study designed to provide a comprehensive health profile of self-reported healthy men and investigate the relationship between vitamin D status, ED, and a range of CVD risk factors. Eligible participants (n=100) completed a comprehensive health assessment including a medical history, anthropometric and cardiovascular assessment, fasting blood sample, computer-based questionnaire, a submaximal fitness test and a handgrip iv strength test. Blood samples were assessed for four common VDR polymorphisms (rs11568820 (Cdx2), rs10735810 (FokI), rs1544410 (BsmI) and rs731236 (TaqI)) using polymerase chain reaction-high resolution amplicon melt (PCR-HRM) analysis. Results The survey showed 38.4% of respondents presented with ED (IIEF-5 ≤21). Older age, non-European ethnicity and current smoking were significant independent predictors of an increased risk of ED, while a high household income and regular vigorous physical activity (PA) were deemed protective. The observational study showed 30 men presented with ED and a further 37 men had <75 nmol/L 25(OH)D. There was a weak positive correlation between IIEF-5 scores and 25(OH)D levels (rs=0.238, p=0.017). Men with <75 nmol/L had lower IIEF-5 scores compared to men with ≥75 nmol/L 25(OH)D (22(7) vs. 24(3), p=0.001). Men with ED had lower 25(OH)D levels compared to men without ED (74.5(34) vs. 84.5(24), p=0.062). Every 1 nmol/L of 25(OH)D predicted a 2% decrease in the age-adjusted risk of ED (age-adjusted OR=0.98 [0.96-1.00], p=0.046). The PCR-HRM analysis showed that the Cdx2, FokI and BsmI polymorphisms were all significantly associated with an adverse cardiovascular risk profile. The Cdx2 G allele was associated with lower IIEF-5 scores compared to the A allele (23(4) vs. 24(2), p=0.008) and the GA and GG genotypes were predictors of an increased age-adjusted risk of ED (age-adjusted OR=18.78 [1.98-178.60], p=0.011 and 8.53 [1.00-72.73], p=0.050 respectively). However, Cdx2 was not found to modify the age-adjusted association between 25(OH)D levels and ED (multi-adjusted OR=0.97 [0.95-1.00], p=0.032). Conclusions These results suggest that over a third of NZ men aged 40-70 years suffer from ED and it is associated with sociodemographic, lifestyle and medical factors simliar to CVD. Low serum 25(OH)D is associated with the presence and severity of ED in a self-reported healthy population. Common VDR polymorphisms are also associated with ED; however, they do not modify the association between serum 25(OH)D and ED. A randomised placebo-controlled human intervention trial is warranted to investigate whether improving vitamin D status in men with vitamin D deficiency and ED ameliorates symptoms and reduces the risk of CVD

Endocrinologic Control of Men's Sexual Desire and Arousal/Erection

Several hormones and neurotransmitters orchestrate men's sexual response, including the appetitive (sexual desire) and consummative (arousal and penile erection) phases. AIM: To provide an overview and recommendations regarding endocrinologic control of sexual desire and arousal and erection and their disturbances. METHODS: Medical literature was reviewed by the subcommittee of the International Consultation of Sexual Medicine, followed by extensive internal discussion, and then public presentation and discussion with other experts. The role of pituitary (prolactin, oxytocin, growth hormone, and α-melanocyte-stimulating hormone), thyroid, and testicular hormones was scrutinized and discussed. MAIN OUTCOME MEASURES: Recommendations were based on grading of evidence-based medical literature, followed by interactive discussion. RESULTS: Testosterone has a primary role in controlling and synchronizing male sexual desire and arousal, acting at multiple levels. Accordingly, meta-analysis indicates that testosterone therapy for hypogonadal individuals can improve low desire and erectile dysfunction. Hyperprolactinemia is associated with low desire that can be successfully corrected by appropriate treatments. Oxytocin and α-melanocyte-stimulating hormone are important in eliciting sexual arousal; however, use of these peptides, or their analogs, for stimulating sexual arousal is still under investigation. Evaluation and treatment of other endocrine disorders are suggested only in selected cases. CONCLUSION: Endocrine abnormalities are common in patients with sexual dysfunction. Their identification and treatment is strongly encouraged in disturbances of sexual desire and arousal

The Impact of poor glycaemic control on the prevalence of erectile dysfunction in men with type 2 Diabetes Mellitus: A Systematic Review.

To determine the impact of poor glycaemic control on the prevalence of erectile dysfunction among men with type 2 Diabetics aged 27 to 85 years.The databases Embase classic+Embase, Global health, Ovid Medline and PsychINFO, were searched for relevant studies in June 2014 using the keywords: (Diabetes Mellitus OR diabetes mellitus type2 OR DM2 OR T2DM OR insulin resistance) AND (erectile dysfunction OR sexual dysfunction OR impotence) AND glycaemic control.All study settings were considered (primary care, secondary care and tertiary care setting).Type 2 Diabetic Patients with erectile dysfunction.Included studies must include one of the following outcomes: (1) HBA1c for assess the level of glycaemic control; (2) Erectile dysfunction (any stage: IIEF-5 = 21 or less).Five cross-sectional studies involving 3299 patients were included. The findings pointed to a positive association between erectile dysfunction and glycaemic control. Three studies showed a significant positive association, while one study showed only a weak correlation and one study showed borderline significance. Patients age, diabetes mellitus duration, peripheral neuropathy and body mass index had positive association with erectile dysfunction. However, smoking and hypertension were not associated with erectile dysfunction in most included studies. Physical activity had a protective effect against erectile dysfunction.We may conclude that the risk of erectile dysfunction is higher in type 2 diabetic men with poor glycaemic control than those with good control

Sexual Dysfunctions in Psoriatic Patients

Psoriasis is a chronic, immune-mediated disorder with a worldwide occurrence characterized by well-defined infiltrated erythematous papules and plaques, covered by silvery white or yellowish scales. It is a physically, socially and emotionally invalidating disorder that affects 1-2% of the population. Sexual health is an important part of general health and sexual dysfunctions can negatively affect self-esteem, confidence, interpersonal relationships and the quality of life. Dermatology Life Quality Index (DLQI), Psoriasis Disability Index (PDI) and the Impact of Psoriasis on Quality of Life (IPSO) questionnaire are all questionnaires used to assess the quality of life of patients with psoriasis and each has one question regarding sexual dysfunction. Several scales were also designed to particularly assess sexual satisfaction in men and women. The aim of this paper is to perform an overview of the existing studies on sexual dysfunction in psoriatic patients

Non-neural phenotype of spinal and bulbar muscular atrophy: Results from a large cohort of Italian patients

Objective: To carry out a deep characterisation of the main androgen-responsive tissues involved in spinal and bulbar muscular atrophy (SBMA). Methods: 73 consecutive Italian patients underwent a full clinical protocol including biochemical and hormonal analyses, genitourinary examination, bone metabolism and densitometry, cardiological evaluation and muscle pathology. Results: Creatine kinase levels were slightly to markedly elevated in almost all cases (68 of the 73; 94%). 30 (41%) patients had fasting glucose above the reference limit, and many patients had total cholesterol (40; 54.7%), low-density lipoproteins cholesterol (29; 39.7%) and triglyceride (35; 48%) levels above the recommended values. Although testosterone, luteinising hormone and follicle-stimulating hormone values were generally normal, in one-third of cases we calculated an increased Androgen Sensitivity Index reflecting the presence of androgen resistance in these patients. According to the International Prostate Symptom Score (IPSS), 7/70 (10%) patients reported severe lower urinal tract symptoms (IPSS score >19), and 21/73 (30%) patients were moderately symptomatic (IPSS score from 8 to 19). In addition, 3 patients were carriers of an indwelling bladder catheter. Videourodynamic evaluation indicated that 4 of the 7 patients reporting severe urinary symptoms had an overt prostate-unrelated bladder outlet obstruction. Dual-energy X-ray absorptiometry scan data were consistent with low bone mass in 25/61 (41%) patients. Low bone mass was more frequent at the femoral than at the lumbar level. Skeletal muscle biopsy was carried out in 20 patients and myogenic changes in addition to the neurogenic atrophy were mostly observed. Conclusions: Our study provides evidence of a wide non-neural clinical phenotype in SBMA, suggesting the need for comprehensive multidisciplinary protocols for these patients. \ua9 2016 Published by the BMJ Publishing Group Limited

Prevalence of Peyronie's Disease-Like Symptoms in Men Presenting With Dupuytren Contractures.

IntroductionPeyronie's disease (PD) and Dupuytren contractures (DC) are often comorbid and are believed to have a similar underlying pathophysiologic mechanism.AimTo investigate the prevalence of PD-like symptoms (PDLS) in men with DC.MethodsFrom October 2013 to December 2016, men who were seen and evaluated for DC were offered the opportunity to participate in an anonymous survey. The survey assessed several basic demographic and sexual health factors and included items from the International Index of Erectile Function and the Erection Hardness Scale. Men who reported PDLS were asked a series of questions derived from the Peyronie's Disease Questionnaire and for their opinions on theoretical treatment modalities for sexual problems and penile deformity.Main outcome measurePrevalence of PDLS in men with DC.ResultsOne hundred forty men with DC were invited to participate; 85 surveys were returned (response rate&nbsp;= 61%). Twenty-two respondents (26%, 95% confidence interval&nbsp;= 17-35) reported PDLS. Approximately one fourth of all respondents had an Erection Hardness Scale score lower than 3. The most common specific PDLS concerns were penile curvature (91%), length loss (55%), narrowing (36%), and hinging (32%). In men with PDLS, 73% felt at least a little bothered by the symptoms when attempting sexual activity and 40% reported having sex less frequently because of the symptoms. Just 27% of men with PDLS had ever used a treatment for a sexual concern. In terms of treatments for penile deformities, 64% of men with PDLS expressed an interest in treatment administered in the form of an in-office procedure; 41% were potentially amenable to a surgical procedure.ConclusionThe prevalence of PDLS in men with DC is similar to the prevalence of DC in men diagnosed with PD. A substantial number of these men have distress and would consider standard-of-care treatments for PD. Shindel AW, Sweet G, Thieu W, et&nbsp;al. Prevalence of Peyronie's Disease-Like Symptoms in Men Presenting With Dupuytren Contractures. Sex Med 2017;5:e135-e141

Readability and understandability of andrology questionnaires

Objective: Medical questionnaires, which enable collection, comparison and analysis of appropriate data as a means of written communication between a patient and a doctor, must be easily readable, and understandable. Here, we measure the readability and understandability of questionnaires used in andrology and examine the relationship between the educational status of the patients and the understandability of the forms. Material and methods: Seven questionnaires used to diagnose andological diseases were selected from the European Association of Urology guidelines. The number of syllables per word, the number of words in a sentence, and the average word and sentence lengths were calculated for each Turkish validated form. Readability scores were calculated, and closet tests were used to measure the understandability of the texts. Results: Three hundred and twenty-seven male volunteers participated in the study. Two hundred and sixteen of the participants (66%) had a high school or college education. The readability level of the seven forms was determined to be ''Difficult'' or ''Very Difficult,'' and at least a high school education level was required to understand the forms. As education level and monthly income increased, the understandability of the forms increased; as the readability of the forms became more difficult, their understandability decreased (p<0.001). Conclusion: The readability levels of questionnaires used in andrology are well above the reading level of Turkey. Health providers can help patients to fill out forms to increase doctor-patient communication