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Erectile Dysfunction
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1. Optimizing outcomes of oral therapy for patients with erectile dysfunction.
Match Strength: 11.397

The evaluation and treatment of erectile dysfunction (ED) differs from that of many medical conditions. An intimate dialogue between the patient and physician must be established for accurate assessment of ED severity and successful therapy. Patient and partner education on the nuances of oral phosphodiesterase inhibitor therapy is important to maximize treatment success with this currently first-line therapy. Realistic expectations for the erectile response and patience are necessary to resume satisfactory sexual functioning. Relationship issues or partner resistance can contribute to a ... Read More »
» Published in Rev Urol. 2003;5 Suppl 7:S28-34.

2. Endothelial dysfunction, erectile dysfunction, and coronary heart disease: the pathophysiologic and clinical linkage.
Match Strength: 11.102

Our rapidly expanding knowledge regarding the biology of the endothelial cell and the pathophysiology of coronary heart disease (CHD) and endothelial dysfunction indicates important common factors and overlapping clinical presentations. We are, in effect, presented with a new paradigm-that of varying vascular manifestations of disease linked to the functioning of endothelial cell lining. This article reviews these areas of advancement and addresses their clinical implications regarding erectile dysfunction and CHD, as well as the role of the phosphodiesterase-5 inhibitor sildenafil ... Read More »
» Published in Rev Urol. 2003;5 Suppl 7:S21-7.

3. Oral pharmacotherapy and the contemporary evaluation and management of erectile dysfunction.
Match Strength: 9.065

The introduction of phosphodiesterase-5 (PDE-5) inhibitor therapy for the treatment of erectile dysfunction (ED) marked the beginning of a much greater awareness of this condition and its effects on quality of life. Resulting research has provided much data on the etiologies of ED, the risk factors involved, and the connection between ED and atherosclerotic disease. With the ED patient more frequently seeking treatment from his primary care physician, it behooves both urologists and non-urologist physicians to be familiar with the properties of the PDE-5 inhibitors, as well as those of other ... Read More »
» Published in Rev Urol. 2003;5 Suppl 7:S9-S20.

4. Efficacy of sildenafil citrate in treatment of erectile dysfunction: impact of associated premature ejaculation and low desire.
Match Strength: 9.037

OBJECTIVES: To assess the effect of premature ejaculation (PE) and low desire on the efficacy and satisfaction rate of sildenafil in the treatment of erectile dysfunction (ED). METHODS: A total of 586 male patients with ED in association with and without PE or low desire were enrolled in this study. Patients were screened for ED using the International Index for Erectile Function. All patients were also screened for PE and low desire. We compared the responses to the erectile function domain, questions 3 and 4, before and after sildenafil in patients with and without PE or low desire. Overall ... Read More »
» Published in Urology. 2006 Sep;68(3):642-7. Epub 2006 Sep 18.

5. Nonpharmacologic treatment of erectile dysfunction.
Match Strength: 9.023

Nonpharmacologic treatment for erectile dysfunction (ED) includes sex therapy, the use of vacuum erection devices, penile prosthesis implantation, and penile vascular surgery. Sex therapy is indicated for psychogenic ED and is at times a useful adjunct for other treatments in men with mixed psychogenic and organic ED. Vacuum erection devices produce usable erections in over 90% of patients; however, patient and partner acceptability is an issue. Three-piece inflatable penile prostheses create flaccidity and an erection that comes close to that which occurs naturally. Penile vascular surgery ... Read More »
» Published in Rev Urol. 2002;4 Suppl 3:S9-S16.

6. Advances in the Management of Post-Radical Prostatectomy Erectile Dysfunction: Treatment Strategies When PDE-5 Inhibitors Don't Work.
Match Strength: 8.727

Phosphodiesterase type-5 (PDE-5) inhibitors have revolutionized the treatment of post-radical prostatectomy erectile dysfunction. For those patients who undergo a non-nerve-sparing radical prostatectomy or whose condition fails to respond to PDE-5 inhibitors, alternative treatment with intracavernous injection therapy, transurethral alprostadil, vacuum erection devices, and recently described combination therapy is available. The goals of therapy are to provide the patient with a means of obtaining an erection so that the patient and his partner may resume sexual relations as soon as possible ... Read More »
» Published in Rev Urol. 2005;7 Suppl 2:S39-50.

7. Detection of sildenafil analogues in herbal products for erectile dysfunction.
Match Strength: 8.724

Sildenafil, the active ingredient in Viagra (Pfizer), is a prescription medicine used for erectile dysfunction. Compounds with chemical structures similar to that of sildenafil were isolated and purified during the analysis of some herbal products marketed for treatment of erectile dysfunction. Structural elucidation using liquid chromatography-diode array detection, infrared spectroscopy, liquid chromatography-tandem mass spectrometry, and nuclear magnetic resonance spectroscopy confirmed that the compounds were homosildenafil, hydroxyhomosildenafil, and acetildenafil. The implications of ... Read More »
» Published in J Toxicol Environ Health A. 2006 Nov;69(21):1951-8.

8. Neuroregenerative strategies after radical prostatectomy.
Match Strength: 8.574

Patients with erectile dysfunction (ED) following radical prostatectomy (RP) continue to present to practicing urologists. Although nerve-sparing RP has decreased the rates of ED significantly, new therapies for cavernosal nerve protection and recovery are now being developed. This report discusses the many agents available in neuroregeneration and neuroprotection to aid in the recovery of erectile function. Multiple agents and strategies have been used for neuroprotection and neuroregeneration of the cavernosal nerve following RP and in nerve injury models. Many of these agents display ... Read More »
» Published in Rev Urol. 2005;7 Suppl 2:S26-32.

9. Sexual dysfunction after radical prostatectomy.
Match Strength: 8.300

Sexual dysfunction associated with radical retropubic prostatectomy (RRP) may start before the surgery. Men undergoing RRP frequently have some degree of sexual dysfunction. In addition to the psychological stress of the diagnosis, the biopsy may itself have a detrimental effect. After surgery, all men will experience loss of ejaculate, because the organ responsible for ejaculate has been removed. Orgasm quality is adversely affected in many men. Erectile dysfunction is immediate and recovery from it is slow. Initially, phosphodiesterase (PDE)-5 inhibitors do not work, and they take up to 18 ... Read More »
» Published in Rev Urol. 2005;7 Suppl 2:S3-S10.

10. Erectile dysfunction after PlasmaKinetic vaporization of the prostate: incidence and risk factors.
Match Strength: 8.273

PURPOSE: To determine the incidence of erectile dysfunction (ED) after PlasmaKinetic vaporization of the prostate (PKVP) using objective and subjective parameters and risk factors. PATIENTS AND METHODS: A total of 153 men completed a questionnaire detailing perceived sexual dysfunction and underwent nocturnal penile-tumescence testing using the RigiScan for three consecutive nights 3 or 4 days preoperatively and 3 months postoperatively. The International Index of Erectile Function (IIEF)-5 scores were obtained preoperatively and postoperatively. Full details of each operation were recorded, ... Read More »
» Published in J Endourol. 2006 Sep;20(9):693-7.

11. PDE-5 Inhibitor Therapy for Erectile Dysfunction Secondary to Nerve-Sparing Radical Retropubic Prostatectomy.
Match Strength: 8.084

The majority of patients receiving therapy for erectile dysfunction (ED) following post-radical retropubic prostatectomy (RRP) are treated with phosphodiesterase (PDE)-5 inhibitors, which seem to have variable efficacy in this population. So far, the only head-to-head trials with PDE-5 inhibitors have been in general ED patients and not in post-RRP patients. Both vardenafil and tadalafil failed to meet statistical noninferiority to sildenafil in head-to-head trials. To date, only sildenafil has demonstrated efficacy in the prevention of post-nerve-sparing RRP ED. The selection of a PDE-5 ... Read More »
» Published in Rev Urol. 2005;7 Suppl 2:S33-8.

12. Asking the questions and offering solutions: the ongoing dialogue between the primary care physician and the patient with erectile dysfunction.
Match Strength: 8.037

Primary care physicians are becoming more involved in inquiry about and management of erectile dysfunction (ED). This relatively new occurrence is appropriate considering that the presence of ED may signal potentially serious medical conditions and that ED is a condition with true morbidity. Addressing sexual issues in the office setting requires a comforting and secure atmosphere in which patients can easily discuss their problems. Because many men are hesitant to approach physicians with their sexual problems, clinicians need to be proactive by asking direct questions, either verbally or in ... Read More »
» Published in Rev Urol. 2003;5 Suppl 7:S35-48.

13. Peyronie's Disease: A Review.
Match Strength: 8.002

Peyronie's disease is an acquired benign condition without known systemic sequelae with presenting symptoms that include the presence of a plaque or induration of the penile shaft, penile curvature or deformity during erection, penile pain, and erectile dysfunction. This article reviews the natural history of the disease, discusses the disease's etiology (widely thought to involve minor penile trauma with subsequent aberrant wound healing), and outlines proper clinical evaluation of Peyronie's disease patients. Medical treatments can be systemic (colchicine, potassium aminobenzoate, vitamin E) ... Read More »
» Published in Rev Urol. 2003 Summer;5(3):142-8.

14. Pharmacologic treatment of erectile dysfunction.
Match Strength: 7.662

Penile erection occurs in response to cavernous smooth muscle relaxation, increased blood flow to the penis, and restriction of venous outflow. These events are regulated by a spinal reflex relying on visual, imaginative, and olfactory stimuli generated within the central nervous system (CNS) and on tactile stimuli to the penis. Drugs can have a facilitatory or inhibitory effect either on the nerves regulating this reflex or on the cavernous smooth muscle. A balance between contractile and relaxant factors governs flaccidity/rigidity within the penis. Drugs that raise cytosolic calcium either ... Read More »
» Published in Rev Urol. 2002;4 Suppl 3:S17-25.

15. Managing early ejaculation: what does the future hold?
Match Strength: 7.470

Recent attention in the field of male sexual dysfunction has focused on erectile dysfunction. However, premature ejaculation (PE) is an extremely common condition that warrants clinical study and exploration of pharmacologic treatments. Until recently, PE was thought to be a behavioral problem for which the best remedy was a learned control technique. However, some drugs currently on the market, including sildenafil and the selective serotonin reuptake inhibitors, appear to have efficacy in the treatment of PE. More research is needed before FDA approval of such agents for this indication, but ... Read More »
» Published in Rev Urol. 2004 Winter;6(1):5-10.

16. Measuring quality of life: the development and initial validation of the patient-reported erectile function assessment instrument.
Match Strength: 7.044

OBJECTIVES: Erectile dysfunction (ED) is a complex condition, which is variously influenced by physical, emotional, societal, and relationship factors. ED has serious implications for the quality of life (QoL) enjoyed by an affected male and his partner. It is very important, therefore, to understand the impact of ED on the QoL of those affected by it. Our objective was to determine if the eight-question Patient Reported Erectile Function Assessment (PREFA) could act as an independent, comprehensive disease-specific instrument in the assessment of QoL as it is impacted by ED. METHODS: During ... Read More »
» Published in Int J Technol Assess Health Care. 2006 Summer;22(3):372-8.

17. Presence of LDL modified by myeloperoxidase in the penis in patients with vascular erectile dysfunction: a preliminary study.
Match Strength: 7.007

OBJECTIVE: Erectile dysfunction (ED) is a major vascular disorder. Atherosclerosis is closely related to lipoprotein metabolism and especially, oxidative modifications of low-density lipoproteins (LDLs), which are involved in early development of the atherosclerotic lesions. Current major questions include how LDLs are oxidised (OxLDL) in vivo. Myeloperoxidase (MPO) is an enzyme present in the azurophile granules of neutrophils and monocytes that can contribute to LDL oxidation in the presence of H(2)O(2). We have developed a new monoclonal antibody against LDL modified by MPO (Mox-LDL) and ... Read More »
» Published in Eur Urol. 2007 Jan;51(1):262-8; discussion 268-9. Epub 2006 Sep 8.

18. Effect of sildenafil citrate treatment on serum dehydroepiandrosterone sulfate levels in patients with erectile dysfunction.
Match Strength: 6.498

OBJECTIVES: To investigate the effect of sildenafil citrate treatment on serum dehydroepiandrosterone sulfate (DHEAS) levels in patients with erectile dysfunction (ED). METHODS: A total of 124 men with a mean age of 45.9 years were included in the study. Group 1 consisted of 78 patients with ED, as determined by the Sexual Health Inventory of Male (SHIM) scale (score less than 21). Group 2 consisted of 46 healthy men with a SHIM score of 21 or greater. The 78 patients with ED took 100 mg sildenafil citrate at least eight times in 1 month. The SHIM scale was administered and serum DHEAS levels ... Read More »
» Published in Urology. 2006 Sep;68(3):626-30. Epub 2006 Sep 18.

19. Cavernous nerve stimulation and interposition grafting: a critical assessment and future perspectives.
Match Strength: 5.218

The sexual dysfunction that results from radical prostatectomy for carcinoma of the prostate is well established, with the degree of macroscopic preservation of the cavernous nerves tied to the degree of postoperative recovery of erectile function that is possible. In addition to the use of preoperative neuroprotective drugs and postoperative erectogenic agents, intraoperative nerve stimulation and grafting offer promise. Nerve stimulation may serve as a predictor of postoperative potency, and nerve grafting offers a potential way to correct the damage that occurs during wide resection. This ... Read More »
» Published in Rev Urol. 2005;7 Suppl 2:S18-25.

20. Health identities: from expert patient to resisting consumer.
Match Strength: 4.843

This article explores the formation of 'health identities': embodied subjectivities that emerge out of complex psychosocial contexts of reflexive modernity, in relation to data on health and illness practices among groups of people and patients using medical technologies including weight-loss drugs and the erectile dysfunction drug sildenafil (Viagra). We examine a range of health identities, from the 'expert patient'--a person who broadly adopts a biomedical model of health and illness, to a 'resisting consumer', who fabricates a health identity around lay experiential models of health and ... Read More »
» Published in Health (London). 2006 Oct;10(4):461-79.

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