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Infertility Diagnosis and Treatment
Published in Sujoy K. Guba, Bioengineering in Reproductive Medicine, 2020
Arteriography for the penis is performed by methods similar to those followed for the limbs and other organs where a radio-opaque dye is injected and the passage through the blood vessel is followed by radiography. Patients are anesthetized and intracavernous injection of saline is given to obtain erection.55 By fluoroscopy or by serial X-ray imaging the path of the flow of the dye is followed. Vascular narrowing and occlusions can be detected.
Erectile Dysfunction
Published in Botros Rizk, Ashok Agarwal, Edmund S. Sabanegh, Male Infertility in Reproductive Medicine, 2019
Mark Johnson, Marco Falcone, Tarek M. A. Aly, Amr Abdel Raheem
Intracavernous injection (ICI) (Figure 12.3): Patients who do not respond to oral therapy may be candidates for ICI of vasoactive agents. After the ICI of the agent, an erection is achieved after 15–20 minutes. The intracavernous alprostadil (Caverject™) represents, to date, the only drug approved for ICI therapy. Alternatively, combination therapy of various agents (papaverine, phentolamine, and vasoactive intestinal peptide) may be considered in off-label settings.
Priapism
Published in J Kellogg Parsons, E James Wright, The Brady Urology Manual, 2019
Mohamad E Allaf, Trinity J Bivalacqua
History: Erection durationPrevious episodesIntracavernous injectionsTraumaPainMedications (prescribed, over-the-counter, and illicit drugs)Hematological malignancy or sickle cellBaseline erectile function.
Recent advances in stem cell therapy for erectile dysfunction: a narrative review
Published in Expert Opinion on Biological Therapy, 2023
Bohan Wang, Wenjun Gao, Micha Y. Zheng, Guiting Lin, Tom F Lue
Protegerou et al. (2019) conducted a pilot study to compare the efficacy of intracavernous injection of adipose-derived mesenchymal stem cells (ADMSCs) versus platelet lysate (PL) in the treatment of organic ED. Eight men were enrolled, with 5 receiving intracavernous injection of ADMSCs and 3 receiving PL alone. Adipose tissue obtained from lipoaspiration was processed to isolate stem cells, which were expanded in culture, and cells from passage 4 were suspended in 2 mL of PL for intracavernous injection. PL was obtained from 20 mL of the patient’s peripheral venous blood to obtain platelet-rich plasma (PRP), which was stored at −80°C for 48 hours and thawed for injection. The combination therapy group received 38.9 ± 14.4 × 106 ADMSCs in combination with 2.2 ± 0.3 mL of PL, while the other group received 2.3 ± 0.4 mL of PL only. The authors reported that most patients in both groups experienced increased IIEF-5 scores, morning erections, and improved peak systolic velocity, with effects lasting several months [61]. Theoretically, platelet lysate may enhance the effect of ADMSC but the combination is more invasive and costly than the allogeneic placenta or umbilical cord-derived stem cells and bioactive products. Moreover, studies with sham controls and adequately powered clinical trials are needed to determine the efficacy of this combination therapy for the ED [62].
The impact of hyperbaric oxygen therapy on erectile functions and serum testosterone levels in patients with erectile dysfunction
Published in The Aging Male, 2020
Volkan Sen, Mehmet Oguz Sahin, Bora Irer, Evin Koc, Guner Yildiz
Erectile dysfunction (ED) is defined as the persistent inability to attain and maintain an erection sufficient to permit satisfactory sexual performance [1]. ED is a worldwide health problem increasing with aging and has negative impacts on men’s quality of life [2]. The prevalence of ED in 40–70 years old men was detected between 25–52% in previous reports [3–6]. Several treatment modalities can be used in ED; first-line treatment of ED includes oral pharmacotherapy with phosphodiesterase type 5 (PDE 5) inhibitors. Intracavernous injections constitute second-line treatment and surgical treatment (penile prostheses) may be offered to patients as a third line therapy for ED. However new treatment modalities have become popular in recent years including low-intensity extracorporeal shock wave therapy (ESWT) and hyperbaric oxygen therapy (HBOT) as an alternative treatment [7–9].
Phase I and phase II clinical trials for the treatment of male sexual dysfunction—a systematic review of the literature
Published in Expert Opinion on Investigational Drugs, 2018
Paolo Capogrosso, Francesco Montorsi, Andrea Salonia
Epidemiological studies detailed that ED rates range between 10% and 50% for men of 40–70 years of age [1,10]. The high prevalence of this condition has driven the clinical research toward the development of effective drugs to treat ED. Currently, phosphodiesterase type 5 inhibitors (PDE5Is) are suggested as the first-line therapy for ED by most of the International Clinical Guidelines [11], with local intracavernosal (IC) vasoactive agents as a second-line approach (e.g. alprostadil) [9]. Despite the excellent efficacy and safety profile of these oral drugs, there is a nonnegligible amount of nonresponders to PDE5Is [9]. Likewise, a significant number of patients refuse or do not get benefit from intracavernous injections (ICIs) of vasoactive agents [9,12]. Moreover, currently approved pharmacological treatments for ED are all symptomatic, thus providing a temporary improvement of EF without curing the disease; this issue is of particular relevance for young and middle-aged men who may not consent to a life-long treatment without the perspective of being cured.