Erectile dysfunction
|
|
- Willis Booth
- 5 years ago
- Views:
Transcription
1 Erectile dysfunction
2 Good Erectile Function
3 Having good Erections => crucial for all men Because erections & the coitus they allow major pleasure brings self-confidence confirms his state of being a full worthy male
4 Comparison of 2 circumcised human penises, erect (on left) & flaccid (on right).
5 Consensus conference: all men 25 years old & older regardless of sexual dysfunction complaints => should be asked about Erectile Dysfunction RESULTS: Erectile dysfunction = common = early manifestation of atherosclerosis & a precursor to systemic vascular disease. Endothelial dysfn = etiologic factor linking ED & cardiovascular disease CCL: The recognition of ED as an early sign of systemic cardiovascular disease offers an opportunity for prevention, partc. in high-risk & underserved minority populations. The algorithm stipulates that All men 25 years old & older regardless of sexual dysfunction complaints should be asked about Erectiel Dysfunction The presence of ED => should prompt an aggressive assessment for cardiovascular risk & occult systemic vascular disease Billups KL, Bank AJ, Padma-Nathan H, Katz S, Williams R. Erectile dysfunction is a marker for cardiovascular disease: results of theminority health institute expert advisory panel. : J Sex Med Jan;2(1):40-50; discussion The Epicenter for Sexual Health & Medicine, University of Minnesota School ofmedicine, Minneapolis, USA. klbillups@earthlink.net
6 Erectile dysfunction
7 Normal erection Erectile dysfunction
8
9 Erectile dysfunction = the inability to achieve &/or maintain an erection sufficient to permit satisfactory sexual intercourse Most cases of erectile dysfunction have a vascular etiology &, in patients with known cardiovascular disease, the degree of erectile dysfunction correlates with severity of that disease. In addition, cardiovascular disease and erectile dysfunction share the same risk factors for atherosclerosis & have a common pathophysiology (endothelial dysfunction); thus, erectile dysfunction appears asan early and sentinel symptom in patients with occult vascular disease, of the coronary or carotid arteries Sekoranja L, Bianchi-Demicheli F, Gaspoz JM, Mach F. [Erectile dysfunction: a potential useful marker for cardiovascular disease] Rev Med Suisse Mar 22;2(58):774-6, 778. Departement de psychiatrie, HUG, Geneve. lucka.sekoranja@hcuge.ch
10 Having no good Erections (Erectile dysfunction) => dramatic for all men A man who has no good erections anymore feels this as: major depersonalization major loss of malehood major loss of self-worth = beginning of a process that will cause a premature death
11
12 Aging & BMI => erectile dysfunction Erectile dysfunction Increased age (% of men) Increase in Erectile dysfn risk by 8.2% per year Increase in Erectile dysfn risk by 7.6% per kg/m² BMI. Higher BMI n = 675 workers (age range 45 to 60 yrs old) 5 45 y +3 50y y y kg/m² kg/m² kg/m² kg/m² +15 kg/m² Figure: An increase in erectile dysfunction risk was observed by 8.2% per year and by 7.6% per kg/m BMI. Kratzik CW, Schatzl G, Lunglmayr G, Rucklinger E, Huber J. The impact of age, body mass index and testosterone on erectile dysfunction. J Urol Jul;174(1):240-3 Department of Urology, Medical University of Vienna, Vienna
13 Statin Therapy => Erectile dysfunction Mean International Index of Erectile Function (IIEF) score (range 0-25) n = 93 men Prior to statin therapy 21 After 6 months of statin therapy - 69 % Figure: Statin therapy reduced the IIEF score. Differences in dose, relative efficacy or relative lipophilicity of statin prescribed showed no correlation with change in IIEF score. Solomon H, Samarasinghe YP, Feher MD, Man J, Rivas-Toro H, Lumb PJ, Wierzbicki AS, Jackson G. Erectile dysfunction and statin treatment in high cardiovascular risk patients. Int J Clin Pract Feb;60(2):141-5 St. Thomas' Hospital, London, UK 6.5 p < % experienced new onset erectile dysfunction Erectile dysfunction following statin therapy is more likely to occur in patients with severe endothelial dysfunction due toage, smoking and diabetes After 6 months of statin therapy, correlations were observed between lower IIEF scores (r = 0.62; p < 0.001) and age and diabetes and weakly with smoking.
14 Hormone Deficiencies That can cause Erectile Dysfunction
15 Testosterone & DHT Deficiencies can cause Erectile Dysfunction
16 DHEAs in men + aging male symptoms & sexual dysfn SUBJECTS: n = 348 patients The patients + total the Aging Male Symptoms (AMS) score of 29 => aging male symptoms the patients + an International Index of Erectile Function IIEF score < than 26 => sexual dysfunction. RESULTS: sign. serum DHEA-S & sign. E2 in the men + aging male symptoms sign. the DHEA-S & free testosterone in the men + sexual dysfunction Serum DHEA-S & free testosterone & age correlated sign. + the IIEF scores. The total AMS score correlated sign. only with age. serum total testosterone, FT, & DHEA-S levels correlated sign. with the andrologic symptoms of AMS the serum E2 correlated + psychological symptoms of AMS. CONCLUSIONS: DHEA-S & E2 might play someimportant roles in the symptoms of aging men. Basar MM, Aydin G, Mert HC, Keles I, Caglayan O, Orkun S, Batislam E. Relationship between serum sex steroids and Aging Male Symptoms score and International Index of Erectile Function. Urology Sep;66(3): Department of Urology, University of Kirikkale, Kirikkale, Turkey.
17 Serum testo Quality of Erection Amplitude & duration Near full erections (in % sleep time spent within 80 % of maximal erection magnitude) (in % of sleep time during which max -erect-magnitude was = or more 1.5 cm) 40 Nocturnal Nl men Penile Erection % Kwan M. J Clin Endocrinol Metab. 1983, 57 : Hypogonadal men - 62 % 13 Nl men 13 Hypogonadal men - 46 % Figure : Poor amplitude & duration of nocturnal erections in hypogonadal men. 7
18
19 Improving Erectile Function
20
21 Erections Stimuli => Hypothalamus => Pituitary gland secretes hormones Stimulation of parasympathic nerves Secretion of NO 2 in genital areas
22 Testosterone Improves Erectile Function
23 2 2.9 ng/ml Penile erection => testosterone level in penis & blood Testosterone level Healthy <men Men + erectile dysfn (ng/ml) Corpus Systemic blood Systemic Corpus Cavernosum (cubital vein) blood Cavernosum 6 Tumescence Tumescence + 30 % Detumescence Tumescence Flaccid Detumescence Tumescence 4 Flaccid % Flaccid Flaccid Figure: In the healthy males, the penile erection was accompanied by an increase in the cavernous & peripheral testosterone concentration, in patients too although in a minimized way. n = 54 healthy males + normal erectile function & 46 patients + erectile fn Becker AJ, Uckert S, Stief CG, Scheller F, Knapp WH, Hartmann U, Jonas U. Cavernous and systemic testosterone lasma levels during different penile conditions in healthy males and patients with erectile dysfunction. Urology. 2001
24 Nocturnal Penile Erection % Testosterone Nocturnal Erections Amplitude & duration (in % sleep time spent within 80 % of maximal erection magnitude) Nl men Hypogonadal men Prior Placebo Testo 200 mg % Near full erections (in % of sleep time during which max -erect-magnitude was = or more 1.5 cm Nl men Hypogonadal men Prior Placebo Testo 200 mg + 87 % 0 Figure : a 200 mg testosterone IM injection stimulates the amplitude & duration of erections in hypogonadal men. Kwan M.J Clin Endocrinol Metab, 1983, 57 :
25 Testosterone erections 100 Transdermal Improvement of Erectile function Placebo oral + 53,2 % IM + 51,3 % 80,9 % % Improvement of erectile function with different testosterone preparations in men w/ erectile dysfunction. Results of a meta-analysis of 16 studies selected out of 73 articles published between Jain P, Rademaker AW, McVary KT. : Testosterone supplementation for erectile dysfunction: results of ameta-analysis. J Urol 2000 Aug;164(2):371-5 Departments of Urology and Preventive Medicine, Northwestern University Medical School, Chicago, Illinois, USA.
26 Testosterone => makes Viagra work better
27 Sex fn Satisfactory erections + testo/viagra 70% Testo & Viagra=> erectile fn in Viagra non-responding males No response 30% International Index of Erectile Function (IIEF) scale Question (Q) 3 Prior p < 0.05 Question (Q) 4 Prior Question (Q) 12 Figure: Andriol restored testosterone to normal levels In 84/120 (70%) Viagra non-responders, combined therapy Viagra with Andriol induced satisfactory erections & increased libido. n = 120 diabetic eretile dysfn men, aged yrs, failing to respond at least 3x to 100 mg Viagra Kalinchenko SY, Kozlov GI, Gontcharov NP, Katsiya GV. Oral testosterone undecanoate reverses erectile dysfunction associated with 1.9 p < Prior 1 p < Sexual contacts per month Prior 0.5 p <
28 Rochira V,.,Carani C. Sildenafil improves sleep-related erections in hypogonadal men: evidences from a randomized, placebocontrolled, crossover study of a synergiv role for both testosterone and sildenafil on penile erections. J Androl.Nov.2005 ModenaUni Viagra & testo Men + erectile dysfunction Number of valid erections Placebo (no Testosterone) Sildenafil (no Testosterone) Testosterone + Placebo Testosterone + Sildenafil 1 0 Figure: Synergic action for both testosterone and sildenafil on penile erections n = hypogonadal men; randomised double-blind crossover trial
29 DHEA Improves Erectile Function
30 DHEA & Erectile Dysfunction Erectile function (of the International Index of Erectile Dysfunction- 15 item questionnaire w/ score 1 to 3 w/ 6 questions on erectile fn) (mean domain score; max. score = 30) % 32 % DHEA 45 % 32 % 75 % 28 % 92 % Placebo 22 % 0 wk 8 wk 16 wk 24 wk weeks Figure : impressive improvement of erections after 24 weeks of intake of 50 mg/day of oral DHEA in 20 patients with erectile dysfunction (Reiter)
31 Hormones => Differences => Erectile fn Erectile function Before Main Hormone Sexual appetite Testosterone Melanotan II Sensitivity DHT/Testosterone, Melanotan II Erection Frequency Volume Hardness Persistence Testosterone Melanotan II, GH Melanotan II, GH Melanotan II, GH Orgasm Ejaculation DHT, Oxytocin
32 Inhibition of Prolactin Improves new Erections after orgasm
33 Orgasm => increases PRL (PRL remains still raised 30 after sexual arousal in men SUBJECTS: 10 healthy male volunteers => sexual arousal & orgasm => blood before, during and after masturbation-induced orgasm Orgasm => transient increases in heart rate, blood pressure & noradrenaline plasma levels. Prolactin plasma levels increased during orgasm remained elevated 30 min after orgasm. none of the other plasma conc. Of adrenaline, noradrenaline, cortisol, LH, FSH, ), FSH), GH, beta-endorphin andtestosterone. were sign. affected by sexual arousal and orgasm. Kruger T, Exton MS, Pawlak C, von zur Muhlen A, Hartmann U, Schedlowski M. Neuroendocrine and cardiovascular response to sexual arousal and orgasm in men. Psychoneuroendocrinology May;23(4): Division of Clinical Psychiatry, Hannover Medical School, Federal Republic of Germany.
34 Inhibition of prolactin => sex drive & fn SUBJECTS: 10 healthy males participated => single-blind, placebocontrolled, balanced cross-over design => serum prolactin to high levels (protirelin, 50 µg i.v.) to low physiological levels (cabergoline, 0.5 mg p.o.). => Sexual arousal & orgasm induced by erotic film + masturbation TREATMENT: CABERGOLINE => serum prolactin => sign. all parameters of sexual drive (P<0.05), fn (P<0.01) & positive perception of the refractory period (P<0.01) protirelin => serum prolactin => small, but not sign. of sexual parameters The sexual effects observed from cabergoline were completely abrogated by coadministration of protirelin. CCL: acute changes in prolactin plasma levels may be one factor modulating sexual drive and function.. Krüger TH, Haake P, Haverkamp J, Krämer M, Exton MS, Saller B, Leygraf N, Hartmann U, Schedlowski M. Effects of acute prolactin manipulation on sexual drive and function in males. J Endocrinol Dec;179(3):
35 Peyronie s disease
36 Fibrosis Lapeyronie s disease
37 Peyronie s disease
38 TREATMENTS for Peyronie s disease
39 Peyronie's disease = fibrosis of the penis may be reversed with multiple hormone replacement therapy (DHT, testosterone, GH and possibly hydrocortisone, vit. E depending on a man s deficiencies)
40 Lapeyronie s disease Cause: Fibrosis of the penis caused by a lack of androgens, testosterone and principally DHT Treatment: Testosterone enanthate inj. IM 250 mg every 7 to 10 days..two months, then after every 14 days DHT gel 2.5 % locally every day GH in sufficient doses (from 0,15 mg a day up; Hydrocortisone systemically may be helpful small physiological doses of (if deficiency diagnosed) Vit. E local & systemically (2.000 mg a day) DHEA (20 to 60 mg a day) Melanotan II?????
41 T. HertogheHormone Handbook 2010
42 T. HertogheHormone Handbook 2010
43
44 Mail to website
Testosterone and PDE5 inhibitors in the aging male
Testosterone and PDE5 inhibitors in the aging male Francesco Romanelli Department of Experimental Medicine Medical Pathophysiology, Food Science and Endocrinology Section Sapienza University of Rome 3005
More informationSexual function and dysfunction in men
Georges A. de Boccard,, M.D. Consultant Urologist F.E.B.U. Sexual function and dysfunction in men Geneva Foundation for Medical Education and Research Training Course in Reproductive Health / Sexual Health
More informationSponsored by. Schering. Sidney Glina
Sponsored by Schering Sidney Glina Testosterone and erectile dysfunction Sidney Glina Keywords Androgen Hormone replacement therapy Hypogonadism Impotence Testosterone Abstract The role of testosterone
More informationMALE SEXUAL DYSFUNCTION. Urology Division, Surgery Department Medical Faculty, University of Sumatera Utara
MALE SEXUAL DYSFUNCTION Urology Division, Surgery Department Medical Faculty, University of Sumatera Utara DEFINITION The inability to achieve a satisfactory sexual relationship May involve : - inadequacy
More informationDiagnosis and management of sexual dysfunction. Dr Chris Simpson Consultant Psychiatrist
Diagnosis and management of sexual dysfunction Dr Chris Simpson Consultant Psychiatrist What are we talking about? Male Erectile dysfunction Premature ejaculation Delayed ejaculation Sexual aversion Paraphilia
More informationInternational Index of Erectile Function Questionnaire IIEF
International Index of Erectile Function Questionnaire IIEF Instructions: These questions ask about the effects your erections have had on your sex life, over the past 4 weeks. Please answer the following
More informationManaging the Patient with Erectile Dysfunction: What Would You Do?
Managing the Patient with Erectile Dysfunction: What Would You Do? Florida A & M University College of Pharmacy and Pharmaceutical Sciences 42 nd Annual Clinical Symposium Wayne A. Sampson, M.D. Cross
More information/04/ /0 Reprinted from Vol. 172, , August 2004 THE JOURNAL OF UROLOGY
0022-5347/04/1722-0658/0 Reprinted from Vol. 172, 658 663, August 2004 THE JOURNAL OF UROLOGY Printed in U.S.A. Copyright 2004 by AMERICAN UROLOGICAL ASSOCIATION DOI: 10.1097/01.ju.0000132389.97804.d7
More informationTestosterone therapy in erectile dysfunction
The Aging Male 2004;7:312 318 Testosterone therapy in erectile dysfunction R. Department of Urology, Columbia University, New York, USA Key words: TESTOSTERONE, TESTOGEL 1, ERECTILE DYSFUNCTION, HYPOGONADISM,
More informationSexual dysfunction of chronic kidney disease. Razieh salehian.md psychiatrist
Sexual dysfunction of chronic kidney disease Razieh salehian.md psychiatrist Disturbances in sexual function are a common feature of chronic renal failure. Sexual dysfunction is inversely associated with
More informationErectile Dysfunction: A Primer for Primary Care Providers
Erectile Dysfunction: A Primer for Primary Care Providers Jeanne Martin, DNP, ANP-BC Objectives 1. Understand the definition, incidence and prevalence of Erectile Dysfunction in the U.S. 2. Understand
More informationDefined as the consistent inability to attain and maintain an erection adequate for sexual intercourse Usually qualified by being present for several
Defined as the consistent inability to attain and maintain an erection adequate for sexual intercourse Usually qualified by being present for several months and occurring at least half the time. Vinik
More information, David Stultz, MD. Erectile Dysfunction. David Stultz, MD September 10, 2001
Erectile Dysfunction David Stultz, MD September 10, 2001 Case Presentation A 66 year old male presents to your office requesting Viagra. He states that for the past year he has had difficulty forming
More informationManaging Testosterone Deficiency: A Practical Guide. John Grantmyre MD Professor of Urology Dalhousie University
Managing Testosterone Deficiency: A Practical Guide John Grantmyre MD Professor of Urology Dalhousie University 1 2 Case Study #1 A 59-Year-Old Man with Erectile Dysfunction 3 Case History Robert is a
More informationEffects of acute prolactin manipulation on sexual drive and function in males
357 Effects of acute prolactin manipulation on sexual drive and function in males T H C Krüger, P Haake, J Haverkamp, M Krämer, M S Exton, B Saller 1, N Leygraf 2, U Hartmann 3 and M Schedlowski Department
More informationSexual Dysfunction. Jae Il Kang, Byeong Kuk Ham, Mi Mi Oh, Je Jong Kim, Du Geon Moon. DOI: /kju
www.kjurology.org DOI:10.4111/kju.2011.52.6.416 Sexual Dysfunction Correlation between Serum Total Testosterone and the AMS and IIEF Questionnaires in Patients with Erectile Dysfunction with Testosterone
More informationThe Impact of Mental Illness on Sexual Dysfunction
Balon R (ed): Sexual Dysfunction. The Brain-Body Connection. Adv Psychosom Med. Basel, Karger, 2008, vol 29, pp 89 106 The Impact of Mental Illness on Sexual Dysfunction Zvi Zemishlany Abraham Weizman
More informationAlternative management of hypogonadism Tamoxifen. Emmanuele A. Jannini, MD Tor Vergata University of Rome ITALY
Alternative management of hypogonadism Tamoxifen Emmanuele A. Jannini, MD Tor Vergata University of Rome ITALY eajannini@gmail.com What hypogonadism is? What hypogonadism is? It is an empty glass The two
More informationREPRODUCTIVE ENDOCRINOLOGY OF THE MALE
Reproductive Biotechnologies Andrology I REPRODUCTIVE ENDOCRINOLOGY OF THE MALE Prof. Alberto Contri REPRODUCTIVE ENDOCRINOLOGY OF THE MALE SPERMATOGENESIS AND REPRODUCTIVE BEHAVIOR RELATED TO THE ACTIVITY
More informationThe Role of Testosterone in the Sexual Function. Luiz Otavio Torres President Elect of ISSM Belo Horizonte - Brazil
The Role of Testosterone in the Sexual Function Luiz Otavio Torres President Elect of ISSM Belo Horizonte - Brazil Hormones and Sexual Function Paraventricular Nucleus Stimuli visual Sexual Desire Melatonine
More informationCanadian Undergraduate Urology Curriculum (CanUUC): Erectile Dysfunction
Canadian Undergraduate Urology Curriculum (CanUUC): Erectile Dysfunction Last reviewed July 2014 Objectives 1. Define erectile dysfunction 2. List and classify the risk factors for erectile dysfunction
More informationAdministration of Testosterone and its Rationale in the Treatment of Erectile Dysfunction
ORIGINAL ARTICLE Administration of Testosterone and its Rationale in the Treatment of Erectile Dysfunction *CATM Mowladad 1, HM Rafiqul 2, A Bakhtiar 3, KM Rahman 4, R Shofiqur 5 *1 Prof. Chowdhury ATM
More informationMale Hypogonadism. Types and causes of hypogonadism. What is male hypogonadism? Symptoms. Testosterone production. Patient Information.
Patient Information English 31 Male Hypogonadism The underlined terms are listed in the glossary. What is male hypogonadism? Male hypogonadism means the testicles do not produce enough of the male sex
More informationThe effect of sildenafil on electrostimulation-induced erection in the rat model
(2002) 14, 251 255 ß 2002 Nature Publishing Group All rights reserved 0955-9930/02 $25.00 www.nature.com/ijir The effect of sildenafil on electrostimulation-induced erection in the rat model N Ueno 1,
More informationLow Energy Shockwaves for the Treatment of Erectile Dysfunction Y. Vardi, B. Appel, I Gruenwald
Low Energy Shockwaves for the Treatment of Erectile Dysfunction Y. Vardi, B. Appel, I Gruenwald Neuro-Urology Unit, Rambam Medical Center & the Technion Faculty of Medicine Haifa, Israel 3 crucial questions
More informationDATE BIO# NAME: Last First Middle REFERRING PHYSICIAN NAME: REFERRING PHYSICIAN SPECIALTY (Urologist, Internist, etc.): PRIMARY CARE PHYSICIAN NAME:
DATE BIO# ERECTILE DYSFUNCTION QUESTIONNAIRE NAME: Last First Middle BIRTHDATE: OCCUPATION: REFERRING PHYSICIAN NAME: REFERRING PHYSICIAN SPECIALTY (Urologist, Internist, etc.): PRIMARY CARE PHYSICIAN
More informationThe Comparison of the Effects of Nebivolol and Metoprolol on Erectile Dysfunction in the Cases with Coronary Artery Bypass Surgery
doi: 10.5761/atcs.oa.16-00242 Original Article The Comparison of the Effects of Nebivolol and Metoprolol on Erectile Dysfunction in the Cases with Coronary Artery Bypass Surgery Özcan Gür, MD, 1 Selami
More informationSevere erectile dysfunction is a marker for hyperprolactinemia
(2001) 13, 176±182 ß 2001 Nature Publishing Group All rights reserved 0955-9930/01 $15.00 www.nature.com/ijir Severe erectile dysfunction is a marker for hyperprolactinemia AM Johri 1, JPW Heaton 1 * and
More informationManaging Erectile Dysfunction
Managing Erectile Dysfunction Lewis E. Harpster MD, FACS Urology of Central PA 4/23/16 1 Objectives 1. Review physiologic mechanism of erection 2. Discuss medical management of ED 3. Discuss surgical management
More informationHypogonadism 4/27/2018. Male Hypogonadism -- Definition. Epidemiology. Objectives HYPOGONADISM. Men with Hypogonadism. 95% untreated.
Male Hypogonadism -- Definition - Low T, Low Testosterone Hypogonadism -...a clinical syndrome that results from failure of the testes to produce physiological concentrations of testosterone due to pathology
More informationIC351 (tadalafil, Cialis): update on clinical experience
(2002) 14, Suppl 1, S57 S64 ß 2002 Nature Publishing Group All rights reserved 0955-9930/02 $25.00 www.nature.com/ijir IC351 (tadalafil, Cialis): update on clinical experience 1 * 1 Urological practice,
More informationThe Centre for Men s Health
96 Harley Street (London) and Manchester All Enquiries - +44 (0)20 7486 2277 www.centreformenshealth.co.uk/ This leaflet provides information about: The Centre for Men s Health The conditions we treat:
More informationGUIDELINES ON ERECTILE DYSFUNCTION
16 GUIDELINES ON ERECTILE DYSFUNCTION E. Wespes (chairman), E. Amar, D. Hatzichristou, Dr. F. Montorsi, J. Pryor, Y. Vardi Eur Urol 2002;41:1-5 1. Background, definition and classification Male erectile
More informationInternational Journal of Intellectual Advancements and Research in Engineering Computations
ISSN:2348-2079 Volume-6 Issue-3 International Journal of Intellectual Advancements and Research in Engineering Computations BRAVISSIMO -M Tablets: A Scientifically Formulated Male Libido Enhancer for overall
More informationMoving Beyond Cancer To A New Normal in Intimacy For Men & Their Partners. Presented by Mary Ellen West, RN, MN, CNM AASECT Certified Sex Counselor
Moving Beyond Cancer To A New Normal in Intimacy For Men & Their Partners Presented by Mary Ellen West, RN, MN, CNM AASECT Certified Sex Counselor WHO Definition of Sexuality Central aspect of being human
More informationTHE RELEVANCE OF TESTOSTERONE THERAPY IN MANAGING PATIENTS WITH ERECTILE DYSFUNCTION
THE RELEVANCE OF TESTOSTERONE THERAPY IN MANAGING PATIENTS WITH ERECTILE DYSFUNCTION Aksam A. Yassin MD PhD EdD FEBU Professor of Urology & Human Sexuality Institute of Urology & Andrology, Segeberger
More informationA Proposed Study of Hyperbaric Oxygen Therapy Following Radical Prostatectomy: Effects on Erectile Dysfunction
A Proposed Study of Hyperbaric Oxygen Therapy Following Radical Prostatectomy: Effects on Erectile Dysfunction Anthony J. Bella MD, FRCSC Division of Urology, Department of Surgery and Department of Neuroscience
More informationASSESSMENT OF SEXUAL FUNCTION IN PATIENTS UNDERGOING VASECTOMY USING THE INTERNATIONAL INDEX OF ERECTILE FUNCTION
Clinical Urology International Braz J Urol Official Journal of the Brazilian Society of Urology POST-VASECTOMY SEXUAL FUNCTION Vol. 31 (5): 452-458, September - October, 2005 ASSESSMENT OF SEXUAL FUNCTION
More informationIan Eardley Department of Urology, Leeds Teaching Hospital Trust
Ian Eardley Department of Urology, Leeds Teaching Hospital Trust Assessment of the man with ED Medical therapy for man with ED What to do when pills fail Sexual stimulus Neural pathways Neurotransmitter
More informationERECTILE DYSFUNCTION. & Current Therapies. GP Conference, Rotorua 7-10 June 2012
ERECTILE DYSFUNCTION & Current Therapies GP Conference, Rotorua 7-10 June 2012 Jan Burns & Annie Woodsford Jan: EN, RCpN, BHSc, RPN (USA),MHSc, Member of the Sexual Medicine Society Urology Nurse Specialist
More informationSexuality and End Stage Renal Disease
Sexuality and End Stage Renal Disease Information for patients and families Read this information to learn: How Sexuality and End Stage Renal Disease (ESRD) can cause changes in sexuality What changes
More informationMale circumcision does NOT reduce penile sensitivity. Ira D. Sharlip, M.D. Clinical Professor of Urology UCSF
Male circumcision does NOT reduce penile sensitivity Ira D. Sharlip, M.D. Clinical Professor of Urology UCSF Does male circumcision affect sexual function, sensitivity or satisfaction? a Systematic Review.
More informationMMM. Topic The use of Tadalafil 5mg daily for the treatment of BPH-LUTS
Dr Tan & Partners MMM Vol. 1 No. 1 Morbidity & Mortality Meeting 14 th November 2014 Introduction Topic The use of Tadalafil 5mg daily for the treatment of BPH-LUTS Tadalafil 5mg daily is a well established
More informationERECTION MISDIRECTION: PENILE REHABILITATION & TREATMENTS FOR ERECTILE DYSFUNCTION. Gregory Harochaw Pharmacy Manager Tache Pharmacy (204)
ERECTION MISDIRECTION: PENILE REHABILITATION & TREATMENTS FOR ERECTILE DYSFUNCTION Gregory Harochaw Pharmacy Manager Tache Pharmacy (204) 233-3469 Nerve Function After careful prostatectomy where the erectile
More informationPremature Ejaculation
Premature Ejaculation Patient Information Urology Department Author ID: PH Leaflet Number: Urol 014 Version: 4 Name of Leaflet: Premature Ejaculation Date Produced: November 2016 Review Date: November
More informationSexual Health in Older Adults
Sexual Health in Older Adults Lauren Carpenter, MD UW Division of Gerontology and Geriatric Medicine VA Puget Sound Geriatrics & Extended Care Objectives > Identify barriers to addressing sexual health
More informationMen Getting Older Will Testosterone Keep Him Young?
Men Getting Older Will Testosterone Keep Him Young? Alvin M. Matsumoto, M.D. Associate Director, GRECC V.A. Puget Sound Health Care System Professor, Department of Medicine Division of Gerontology and
More informationOpinion: Yes. PDE-5 inhibitors should be used post radical prostatectomy as erection function rehabilitation?
Difference of opinion Vol. 43 (3): 385-389, May - June, 2017 doi: 10.1590/S1677-5538.IBJU.2017.03.03 PDE-5 inhibitors should be used post radical prostatectomy as erection function rehabilitation? Opinion:
More informationSexual Anatomy. Monday, 30 March 2009
Sexual Anatomy 1 2 3 Fallopian Tube Ovary Uterus Bladder Cervix Pubic bone Clitoris Urethra Rectum Vagina Anus G Spot 4 Variety of Vulvae 5 Bladder Corpus Cavernosum Rectum Seminal Vesicle Prostate Glans
More informationBasics of Male Libido: Dysfunction & Treatment. Ripu Hundal MD FACE First State Endocrinology Newark, DE
Basics of Male Libido: Dysfunction & Treatment Ripu Hundal MD FACE First State Endocrinology Newark, DE Sexual Hormones Steroid hormones Commonly referred to as male sex hormones and female sex hormones,
More informationERECTILE DYSFUNCTION DIAGNOSIS
ERECTILE DYSFUNCTION DIAGNOSIS Head of Andrology and Sexual Medicine Dep.of Urology and Nefrology Hospital Virgen del Rocío ANDROMEDI. Sexual Medicine SEVILLA. SPAIN General Secretary ESSM Natalio Cruz
More informationFind your ED cure End your frustration. Renew your confidence. Feel complete. Take the next steps. Erectile dysfunction and heart disease
Take the next steps Visit your general practitioner or cardiologist to learn more about your risk for cardiovascular disease. Visit EDCure.org to: Take the online ED quiz and get your customized treatment
More informationClinical Case Reports: Open Access
Clinical Case Reports: Open Access Review Vol 1 Iss 1 Erectile Dysfunction: Causes and Diagnosis Afa Bayramova * Department of Reproductive System and Disorders, USA * Corresponding author: Bayramova A,
More informationLate onset hypogonadism
Late onset hypogonadism Farrukh Javid Male Menopause Clinical AND biochemical syndrome Testosterone levels decline by 0.4-3% per year after the age of 30, as opposed to the more rapid decline that occurs
More informationCHAPTER 11: SEXUAL AND GENDER PROBLEMS KEY TERMS
CHAPTER 11: SEXUAL AND GENDER PROBLEMS KEY TERMS Androgens The most important of the male hormones. Unusual sexual behaviour, such as impulsive sexual offending involving non-consenting others, may be
More informationSerum Total Testosterone Level and Identification of Late-Onset Hypogonadism: A Community-Based Study
www.kjurology.org http://dx.doi.org/10.4111/kju.2013.54.9.619 Sexual Dysfunction/Male Infertility Serum Total Testosterone Level and Identification of Late-Onset Hypogonadism: A Community-Based Study Sungmin
More informationClinical Trial Study Synopsis
Clinical Trial Study Synopsis This file is posted on the Bayer HealthCare Clinical Trials Registry and Results website and is provided for patients and healthcare professionals to increase the transparency
More informationRecognizing and Managing Testosterone Deficiency
Recognizing and Managing Testosterone Deficiency J. Bruce Redmon, M.D. Professor Division of Endocrinology Departments of Medicine and Urologic Surgery Disclosure Information I have no financial relationships
More informationFriday, 11 January 13. Sexual Anatomy
Friday, 11 January 13 Sexual Anatomy Friday, 11 January 13 Friday, 11 January 13 Friday, 11 January 13 Friday, 11 January 13 Fallopian Tube Ovary Uterus Bladder Cervix Pubic bone Clitoris Urethra Rectum
More informationEfficacy and Safety of Linear Focused Shockwaves for Erectile Dysfunction (RENOVA) A Second Generation Technology
Efficacy and Safety of Linear Focused Shockwaves for Erectile Dysfunction (RENOVA) A Second Generation Technology Y. Reisman, MD, PhD. 1, A. Hind, MD. 2, A. Varaneckas, MD. 3, I. Motil, MD. 4 1 Men's Health
More informationTestosterone Therapy in Men An update
Testosterone Therapy in Men An update SANDEEP DHINDSA Associate Professor of Medicine Director, Division of Endocrinology and Metabolism, Saint Louis University, St. Louis, MO Presenter Disclosure None
More information13-Oct-15 ERECTILE DYSFUNCTION. Urology Subdepartement dr. Mintohardjo Naval Hospital dr. Isdiyanto Septiadi, Sp.U
ERECTILE DYSFUNCTION Urology Subdepartement dr. Mintohardjo Naval Hospital dr. Isdiyanto Septiadi, Sp.U 1 2 3 So what is impotence or erectile dysfunction..? The persistent inability to achieve or maintain
More informationCorporate Medical Policy Testosterone Pellet Implantation for Androgen Deficiency
Corporate Medical Policy Testosterone Pellet Implantation for Androgen Deficiency File Name: Origination: Last CAP Review: Next CAP Review: Last Review: testosterone_pellet_implantation_for_androgen_deficiency
More informationErectile Dysfunction (ED) Shawn McGee M.D. CentraCare Adult and Pediatric Urology January 30 th, 2016
Erectile Dysfunction (ED) Shawn McGee M.D. CentraCare Adult and Pediatric Urology January 30 th, 2016 Erectile dysfunction: The inability to attain or maintain penile erection sufficient for satisfactory
More informationDisease (diabetic neuropathy, multiple sclerosis, tumors, and, rarely, tertiary syphilis)
COURSES ARTICLE - THERAPYTOOLS.US Individual Planning: A Treatment Plan Overview for Adult Men with Sexual Performance Problems Individual Planning: A Treatment Plan Overview for Adult Men with Sexual
More informationIndex. urologic.theclinics.com. Note: Page numbers of article titles are in boldface type.
Note: Page numbers of article titles are in boldface type. A Acquired hypogonadism, prevalence of, 165 167 primary, 165 secondary, 167 Adipose tissue, as an organ, 240 241 Adrenal hyperplasia, congenital,
More informationDaily vs. on-demand PDE-5 inhibitors for management of erectile dysfunction following treatment for prostate cancer
Daily vs. on-demand PDE-5 inhibitors for management of erectile dysfunction following treatment for prostate cancer Lead author: Nancy Kane Regional Drug & Therapeutics Centre (Newcastle) February 2018
More informationMale Reproductive Structures I. Overview A. Main functions: 1. Produce a haploid male gamete (sperm) 2. Deposit sperm in the female so fertilization
Male Reproductive Structures I. Overview A. Main functions: 1. Produce a haploid male gamete (sperm) 2. Deposit sperm in the female so fertilization may occur! A. Scrotum 1. Muscular pouch that holds the
More informationGUIDELINES ON ERECTILE DYSFUNCTION
GUIDELINES ON ERECTILE DYSFUNCTION (Text updated March 2005) E. Wespes (chairman), E. Amar, D. Hatzichristou, K. Hatzimouratidis, F. Montorsi, J. Pryor, Y. Vardi 88 Erectile Dysfunction Eur Urol 2001;40:97-101
More informationThe Male Andropause. What are the symptoms? What are the risks of hormone deficiencies?
The Male Andropause By: Dr. Sangeeta Pati MD, FACOG Although, the male andropause has not been widely recognized, increased medical research has turned attention to the gradual hormone decline in males
More informationWhat Is the Low T Syndrome? Is Testosterone Supplementation Safe?
What Is the Low T Syndrome? Is Testosterone Supplementation Safe? UCSF Osher Mini Medical School March 7, 2018 Dolores Shoback, MD Staff Physician SF-VAMC Professor of Medicine, UCSF No disclosures or
More information6/14/2010. GnRH=Gonadotropin-Releasing Hormone.
Male Androgen Replacement Mitchell Sorsby, MD June 19, 2010. QUESTION # 1 Which of the following is not a symptom associated with low T levels? a) decreased libido b) erectile dysfunction c) depression
More informationJan Farrell. Nurse Consultant Urology Department of Urology Rotherham General Hospital NHS FT
Jan Farrell Nurse Consultant Urology Department of Urology Rotherham General Hospital NHS FT Aims of session To promote discussion / interaction Opportunity to discuss with peers Promote learning / share
More informationISSM QUICK REFERENCE GUIDE ON TESTOSTERONE DEFICIENCY FOR MEN
International Society for Sexual Medicine - www.issm.info ISSM QUICK REFERENCE GUIDE ON TESTOSTERONE DEFICIENCY FOR MEN Version: September 2015 What is testosterone deficiency? Testosterone deficiency
More informationA USER S GUIDE WHAT EVERY MAN NEEDS TO KNOW
A USER S GUIDE WHAT EVERY MAN NEEDS TO KNOW 1. Why men need to know more Good health is vital for a happy and full life. But, with work and family responsibilities, men often overlook their own health
More informationERECTILE DYSFUNCTION TREATMENTS
ERECTILE DYSFUNCTION TREATMENTS Coverage for services, procedures, medical devices and drugs are dependent upon benefit eligibility as outlined in the member's specific benefit plan. This Medical Coverage
More informationAssessment of Erectile and Ejaculatory Function after Penile Prosthesis Implantation
www.kjurology.org DOI:.4/kju.2.5.3.22 Sexual Dysfunction/Infertility Assessment of Erectile and Ejaculatory Function after Penile Prosthesis Implantation Jang Ho Bae, Phil Hyun Song, Hyun Tae Kim, Ki Hak
More informationTestosterone Therapy in Men with Hypogonadism
Testosterone Therapy in Men with Hypogonadism (Endocrine Society 2018 Guideline) Ngwe Yin, MD Assistant Clinical Professor of Medicine, UCSF Fresno Medical Education Program Disclosures None Objective
More informationHow Long Does It Take For Testosterone Replacement Therapy to Work?
How Long Does It Take For Testosterone Replacement Therapy to Work? When will I feel the effects? Dr Kevin J Meuret How Long Does it Take For Low Testosterone Treatment To Work? Great Question. New clients
More informationTRANSPARENCY COMMITTEE OPINION. 19 July 2006
TRANSPARENCY COMMITTEE The legally binding text is the original French version OPINION 19 July 2006 ANDROCUR 100 mg, scored tablet 3 blister packs 20 tablets : 340 417-5 Applicant: Schering SA cyproterone
More informationERECTION HARDNESS: A UNIFYING FACTOR FOR DEFINING RESPONSE IN THE TREATMENT OF ERECTILE DYSFUNCTION
ERECTION HARDNESS: A UNIFYING FACTOR FOR DEFINING RESPONSE IN THE TREATMENT OF ERECTILE DYSFUNCTION JOHN P. MULHALL, LAURENCE A. LEVINE, and KLAUS-PETER JÜNEMANN ABSTRACT The extensive sildenafil citrate
More informationReview Article Penile Rehabilitation Therapy with PDE-V Inhibitors Following Radical Prostatectomy: Proceed with Caution
Advances in Urology Volume 2009, Article ID 852437, 4 pages doi:10.1155/2009/852437 Review Article Penile Rehabilitation Therapy with PDE-V Inhibitors Following Radical Prostatectomy: Proceed with Caution
More informationClinic for urology, pediatric urology and andrology. Penile diseases. Dr. Arne Hauptmann
Clinic for urology, pediatric urology and andrology JUSTUS- LIEBIG UNVERISTY GIESSEN Penile diseases Dr. Arne Hauptmann Clinic for urology, pediatric urology and andrology University Giessen und Marburg
More informationSidney Glina Faculdade de Medicina do ABC Instituto H. Ellis Editor-in-Chief of the International Brazilian Journal of Urology
Sidney Glina Faculdade de Medicina do ABC Instituto H. Ellis Editor-in-Chief of the International Brazilian Journal of Urology (www.intbrazjurol.com.br) glinas@terra.com.br Conflict of Interest: In the
More informationErectile Dysfunction Case Study 2. Medical Student Case-Based Learning
Erectile Dysfunction Case Study 2 Medical Student Case-Based Learning The Case of Mr. Power s Limp Mojo Mr. Powers develops erectile dysfunction after his radical prostatectomy for prostate cancer. You
More informationManaging Symptoms after Prostate Cancer Sexual Side Effects. Changes in a man s sex life are common and can be managed.
Managing Symptoms after Prostate Cancer Sexual Side Effects Changes in a man s sex life are common and can be managed. Prostate cancer and its treatment often bring changes in a man s sex life, especially
More informationDiagnosis and Clinical Evaluation of Hypogonadism in Adult Patients with Obesity and Diabetes
Diagnosis and Clinical Evaluation of Hypogonadism in Adult Patients with Obesity and Diabetes Adrian Dobs, M.D., M.H.S. Professor of Medicine and Oncology The Johns Hopkins University School of Medicine
More informationErectile Dysfunction and the Prostate Cancer Patient
BAUN & Prostate cancer UK Erectile Dysfunction Study Day Erectile Dysfunction and the Prostate Cancer Patient Lorraine Montgomery Specialist Nurse Practitioner Urology Queen Elizabeth Hospital Gateshead
More informationCentral hemodynamics and prediction of cardiovascular events in patients with erectile dysfunction
Central hemodynamics and prediction of cardiovascular events in patients with erectile dysfunction N.Skliros, N.Ioakeimidis, D.Terentes-Printzios, C.Vlachopoulos Cardiovascular Diseases and Sexual Health
More informationLate onset Hypogonadism. Dr KhooSay Chuan Department of Urology Penang General Hospital
Late onset Hypogonadism Dr KhooSay Chuan Department of Urology Penang General Hospital Late onset hypogonadism(loh) Definition LOH age associated testoteronedeficiency syndrome (TDS) Male menopause, andropause,
More informationAn Evidence-based Review of Clinical Trial Data
An Evidence-based Review of Clinical Trial Data Karen K. Miller, MD Massachusetts General Hospital Harvard Medical School Boston, MA 1 Rationale for Investigating Androgen Administration in Women: Data
More informationMale Sexuality and Cancer. Anne Katz, PhD, RN CancerCare Manitoba August 29, 2012
Male Sexuality and Cancer Anne Katz, PhD, RN CancerCare Manitoba August 29, 2012 Objectives! Recognize the sexual side effects of treatment for cancer in men! Discuss treatment modalities for these problems!
More informationGUIDELINES ON PRIAPISM
GUIDELINES ON PRIAPISM (Text update March 2015) A. Salonia, I. Eardley, F. Giuliano, I. Moncada, K. Hatzimouratidis Eur Urol 2014 Feb;65(2):480-9 Introduction Priapism is a pathological condition representing
More informationThe Investigation and Management of Erectile Dysfunction
Guideline for Administered by the Alberta Medical Association The Investigation and Management of Erectile Dysfunction 00 Update This clinical practice guideline replaces the Alberta Laboratory Endocrine
More informationBiology of Reproduction-Biol 326
Biology of Reproduction-Biol 326 READ ALL INSTRUCTIONS CAREFULLY. ANSWER ALL THE QUESTIONS ON THE ANSWER SHEET. THE ANSWER ON THE ANSWER SHEET IS YOUR OFFICIAL ANSWER REGARDLESS OF WHAT YOU MARK ON THE
More informationChronic Daily Administration of Vardenafil in Erectile Dysfunction Patients Has No Impact on Semen Parameters or on Sex Hormones Levels
Australian Journal of Basic and Applied Sciences, 2(3): 779-784, 2008 ISSN 1991-8178 Chronic Daily Administration of Vardenafil in Erectile Dysfunction Patients Has No Impact on Semen Parameters or on
More informationWITH ERECTILE DYSFUNCTION
Clinical Urology International Braz J Urol Vol. 29 (4): 320-326, July - August, 2003 Official Journal of the Brazilian Society of Urology OF PATIENTS WITH ERECTILE DYSFUNCTION JOAQUIM A. CLARO, SÉRGIO
More informationThe Endocrine System. I. Overview of the Endocrine System. II. Three Families of Hormones. III. Hormone Receptors. IV. Classes of Hormone Receptor
The Endocrine System I. Overview of the Endocrine System A. Regulates long term metabolic processes B. Releases hormones from endocrine cells 1. Hormones are chemicals 2. Alter metabolism of cells 3. Release
More informationMale Reproductive System
21-1 21-2 Reproductive System Male Reproductive System Genital Tract In males the testes, held outside the body in the scrotum (optimum temp of about 35 0 C), produce sperm. Sperm mature in coiled tubes
More information