• Korean Circulation Journal
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• 제52권3호
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• pp.233-242
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• 2022

Background and Objectives: For adult men with congenital heart disease (ACHD), data on erectile dysfunction (ED) is limited. We aimed to assess the frequency of ED, its role in patient-physician communication and to identify parameters predicting ED. Methods: Male ACHD ≥18 years registered at the German National Register for Congenital Heart Defects were invited to participate in an online questionnaire about sexual health. Participants with presumed ED according to International Index of Erectile Function Score were compared to patients without ED. Results: The 371 patients responded to the questionnaire (83% with moderate to highly complex ACHD). The 43% presented with more than mild ED. When ED was present, patients complained about general anxiety to be sexually active more often (p<0.05) and underwent sexual activity less frequently compared to those without ED (p<0.05). Age ≥40 years (odds ratio [OR], 3.04; p=0.002), being single (OR, 6.82; p<0.0001), anxiety to be sexually active (OR, 2.64; p=0.0002) and psychiatric disease (OR, 4.33; p<0.0007) emerged as independent predictors for ED. Overall, patients sought medical advice in 6.7% of cases, whilst 29.6% would appreciate an active approach by the physician to address this sensitive topic. Conclusions: ED is affecting one third to one half of male ACHD according to a questionnaire-based analysis. Older age, being single, fear of sexual activity due to ACHD and psychiatric disorder emerged as independent predictors for ED. These parameters can easily be assessed to identify patients at risk. ED should be addressed proactively by health professionals.

• Clinical and Experimental Reproductive Medicine
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• 제46권4호
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• pp.202-205
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• 2019

Hyperprolactinemia due to a pituitary adenoma is a rare cause of erectile dysfunction (ED). The prevalence of clinically apparent prolactinomas is reported to be from 6-10 to 50 per 100,000. A few reports have been published of prolactinoma presenting with ED. Here, we report a rare case of a young man who presented with ED as a chief complaint and who was diagnosed with a huge prolactinoma, and we discuss a related fertility issue.

• The World Journal of Men's Health
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• 제39권1호
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• pp.123-130
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• 2021

Purpose: To perform real-time quantitative measurements of penile rigidity for patients with erectile dysfunction (ED) using shear-wave elastography (SWE). Materials and Methods: A total of 92 patients with clinically diagnosed ED filled out an abridged five-item version of the International Index of Erectile Function (IIEF-5) questionnaire and underwent SWE as well as penile color Doppler ultrasound (CDUS) after intracavernosal injection for penile erection. Elasticity measurements were repeated on two sites of the corpus cavernosum (central and peripheral elasticity of corpus cavernosum [ECC]) and the glans penis during the erection phase. Correlations between penile elasticity and rigidity scores or IIEF-5 were evaluated statistically. Penile elasticity was also compared with the ED types based on CDUS. Results: The mean age of all patients was 53.5±13.4 years, and the mean IIEF-5 score was 9.78±5.01. The rigidity score and central ECC value demonstrated a significant correlation (r=-0.272; 95% confidence interval: -0.464 to -0.056; p=0.015). The IIEF-5 score was not significantly correlated with penile elasticity. Vascular ED patients showed significantly higher central ECC values than nonvascular ED patients (p<0.001). At a cut-off value of 8.05 kPa, the central ECC had a specificity of 41.5%, a sensitivity of 84.6%, and an area under the ROC curve of 0.720 with a standard error of 0.059 (p=0.019) for predicting vascular ED. Conclusions: Quantitatively measuring Young's modulus of the corpus cavernosum using SWE could be an objective technique for assessing penile erectile rigidity and the vascular subtype in patients with ED.

• 한국자원식물학회지
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• 제31권2호
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• pp.109-116
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• 2018

발기부전(erectile dysfunction, impotence)은 성교과정을 위한 음경이 딱딱하게 발기되지 않거나 유지하지 못하는 것을 말한다. 잦은 발기 부전은 심장 질환, 비만, 알코올 중독, 스트레스, 흡연 및 우울증을 비롯하여 치료가 필요한 건강상의 문제가 원인이 된다. 본 연구는 산수유(Cornus officinalis)를 포함한 복합 추출물이 발기부전 랫드모델에서 성기능과 관련된 인자에 미치는 영향을 알아보고자 하였다. 발기부전 랫드모델은 Cimetidine/5% EtOH를 2주 동안 경구투여하여 유도한 후, 산수유 등 복합추출물을 각각 다른 농도로 경구투여하였다. 그 결과, 산수유 등 복합추출물 처리군(CPL-300, 600, 900 mg/kg)에서 성 기능 인자(NO, cGMP)가 대조군에 비해 유의성 있게 향상되었다. 또한 혈청 테스토스테론은 산수유 등 복합추출물 처리 후 용량 의존적으로 증가하였다. 더욱이, 산수유 등 복합추출물의 투여는 발기부전 랫드모델에서 전립선의 크기를 회복시키는 것을 확인하였다. 결과를 종합하자면 산수유 등 복합추출물이 랫드모델에서 성기능 인자와 테스토스테론을 증가시킴으로써 발기부전을 완화시킨다는 것을 보여 주었고, 이는 산수유 등 복합추출물이 천연 추출물로 향 후 발기부전 치료에 사용될 수 있음을 시사한다. 하지만 산수유 복합추출물의 남성 성기능의 직접적인 연관관계, 유효성분과 그 메커니즘을 자세히 밝히기 위해서는 추가적인 연구가 필요하다고 사료된다.

• Asian Pacific Journal of Cancer Prevention
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• 제17권4호
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• pp.1961-1966
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• 2016

Background: To investigate the prevalence of premature ejaculation (PE) and erectile dysfunction (ED) in a sample of patients with prostate cancer and to determine the utility of the previously suggested cutoffs of the Premature Ejaculation Diagnostic Tool (PEDT) for the diagnosis of PE and that of International Index of Erectile Function (IIEF-5) for ED. Materials and Methods: A total of 1,202 men with prostate cancer were invited from urology clinics at the universities of Iran, Tehran, Qazvin, Ahvaz, Guilan and Tabriz. Clinical characteristics were collected through medical records. PE and ED diagnoses were made by trained urologists. In addition to the clinical diagnoses, PE and ED were measured through self-report using the PEDT and the IIEF-5. Questionnaire cutoff scores were determined using receiver operating characteristic (ROC) curves and confirmed by predictive ability using logistic regression. Results: The prevalence of PE was 63.7% and that of ED was 66.2%. Prevalences of PE decreased and that of ED increased with advanced TNM stages. According to ROC, the suggested cutoff for the PEDT to diagnose a PE was ${\geq}11$ (sensitivity=0.988, 1-specificity=0.084, and predictive ability=0.914) and ${\leq}17$ for the IIEF-5 (sensitivity=0.966, 1-specificity=0.031, and predictive ability=0.967). Conclusions: Prevalence of sexual problems was high in prostate cancer patients in Iran, therefore oncologists should take into account these potential problems when deciding on treatment modalities.

• Clinical and Experimental Reproductive Medicine
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• 제43권1호
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• pp.26-30
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• 2016

Objective: We aimed to investigate the prevalence of erectile dysfunction (ED) and the usage of phosphodiesterase type 5 (PDE5) inhibitors for ED treatment in infertile couples. Methods: A total of 260 male partners in couples reporting infertility lasting at least 1 year were included in this study. In addition to an evaluation of infertility, all participants completed the International Index of Erectile Function (IIEF)-5 questionnaire to evaluate their sexual function. The participants were asked about their use of PDE5 inhibitors while trying to conceive during their partner's ovulatory period and about their concerns regarding the risks of PDE5 inhibitor use to any eventual pregnancy and/or the fetus. Results: Based on the IIEF-5 questionnaire, 41.5% of the participants (108/260) were classified as having mild ED (an IIEF-5 score of 17-21), while 10.4% of the participants (27/260) had greater than mild ED (an IIEF-5 score of 16 or less). The majority (74.2%, 193/260) of male partners of infertile couples had a negative perception of the safety of using a PDE5 inhibitor while trying to conceive. Only 11.1% of men (15/135) with ED in infertile couples had used a PDE5 inhibitor when attempting conception. Conclusion: ED was found to be common in the male partners of infertile couples, but the use of PDE5 inhibitors among these men was found to be very low. The majority of male partners were concerned about the risks of using PDE5 inhibitors when attempting to conceive. Appropriate counseling about this topic and treatment when necessary would likely be beneficial to infertile couples in which the male partner has ED.

• 대한약침학회지
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• 제27권2호
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• pp.82-90
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• 2024

Objectives: Nitric oxide is the most important mediator of penile erection after the onset of sexual excitement. It activates cyclic guanosine monophosphate (cGMP), increasing penile blood flow. Most pharmaceutical medications prevent enzyme phosphodiesterase type 5 (PDE-5) from breaking down cGMP, thus keeping its level high. However, due to the adverse effects of pharmacological therapies, herbal drugs that improve sexual function have gained attention recently. This study aimed to investigate the combined effects of ginseng, Tribulus terrestris, and L-arginine amino acid on the sexual performance of individuals with erectile dysfunction (ED) using the 5-item version of the International Index of Erectile Function (IIEF-5) questionnaire. Methods: Over three months, 98 men with erectile dysfunction were randomly assigned to receive either 500 mg of herbal supplements or placebo pills. Each herbal tablet contained 100 mg of protodioscin, 35 mg of ginsenosides, and 250 mg of L-arginine. Results: The results showed that the changes in the average scores of ILEF-5 within each group before and after the intervention indicated that all parameters related to the improvement of sexual function in patients with erectile dysfunction improved in the herbal treatment group (p < 0.001). The herbal group significantly improved IIEF-5 scores in nondiabetics (p < 0.05). However, there was no significant difference in the changes of IIEF-5 scores between the two intervention and control groups in diabetic patients. Conclusion: In conclusion, ginseng, Tribulus terrestris, and L-arginine have properties that increase energy and strengthen sexual function, making them suitable for patients with sexual disorders.

• 동의생리병리학회지
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• 제27권5호
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• pp.625-630
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• 2013

Erectile dysfunction (ED) is a highly prevalent disorder that affects millions of men worldwide. ED is now considered an early manifestation of atherosclerosis, and consequently, a precursor of systemic vascular disease. Lycii fructus extracts (LFE) were administered for 4 weeks to assess the improving effects on ED. Animals were divided into one normal group and four LFE-treated groups (0, 0.3, 0.6, and 1.2 g/kg). We induced ED in the study animals by oral administration of 20% ethanol instead of water everyday for 4 weeks. This study was designed to investigate the effects of LFE on the mRNA levels of inducible nitric oxide synthase (iNOS) and endothelial NOS (eNOS) expression; NO levels of nitric oxide (NO) and cyclic guanosine monophosphate (cGMP); blood profile; and erectile response of the corpus cavernosum of the rat penis. The libido of the LFE-administered male rats was higher than that of the ethanol control group. The erectile response of the corpus cavernosum was restored after LFE administration, to a level similar to the normal group. In addition, the iNOS in the corpus cavernosum of the male rats administered LFE decreased. In contrast, compared to the control group, LFE-administered male rats showed increased eNOS, NO and cGMP levels in the corpus cavernosum. These results indicate that LFE effectively restored ethanol-induced ED in male rats.

• Natural Product Sciences
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• 제22권1호
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• pp.46-52
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• 2016

Erectile dysfunction (ED) is a highly prevalent disorder that affects millions of men and considered to be an early symptom of atherosclerosis and a precursor of various systemic vascular disorders. The aim of the present study was to prepare ginsenoside Re enriched fraction (GS-F3K1, ginsenoside Re 10%, w/w) from ginseng berries flesh and to investigate the enhanced activities of GS-F3K1 on alcohol-induced ED. GS-F3K1 was prepared by the continuous liquid and solid separating centrifugation and circulatory ultrafiltration from ginseng berries flesh. GS-F3K1 was administered for 5 weeks in ethanol-induced ED rat by oral administration of 20% ethanol. To investigate the effects of GS-F3K1 on ED model, the levels of nitrite expression, cyclic guanosine monophosphate (cGMP) and erectile response of the penile corpus cavernosum of rat were measured. The erectile response of the corpus cavernosum was restored after GS-F3K1 administration, to a level similar to the normal group. The level of nitrite and cGMP expression in the corpus cavernosum of GS-F3K1-administered male rats was increased significantly compared to positive control group. GS-F3K1 from ginseng berries should effectively restore ethanol-induced ED in male rats and could be developed as a new functional food for the elderly men.

• 동의생리병리학회지
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• 제20권3호
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• pp.680-684
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• 2006

This study was designed to investigate effects of KH-304 in improving erectile dysfunction (ED), particularly in terms of nitric oxide (NO)-cGMP pathways. After oral administration of the KH-304 water extract, 1OOmg, 300mg, 500mg or 700mg per 1 kg of Dody weigh for 10days, We examined the expression and activity of two enzyme: neuronal NO synthase (nNOS), endothelial NO synthase (eNOS) and that act upon the major NO-cGMP signaling pathway in penile tissue. Effect of KH-304 on COMP degradation was also examined using bovine vascular smooth muscle cells pretreated with an NO donor, S-nitroso-N-Acetylpenicillamine (SNAP), Also, it examined the endothelial NO synthase (eNOS) for seaching effecting period (100mg, 300mg/kg for 10 and 30days) and peak intracavernous pressures (ICPS) in penile tissues rabbit copus cavernosum contracted by 10-6 M phenylephrine. The severely reduced peak intracavernous pressures (ICPS) in penile tissues were restored completely after KH-304 treatment, and KH-304 treatment significantly made the latency period earlier. Furthermore, the penile expression levels of nNOS, eNOS dependent NOS activities and COMP concentrations were increased significantly in the KH-304 100, 300mg treated rats. These results suggest that KH-304 with high expression of NOS may be useful in erectile dysfunction.